Proximal femoral allografting in revision total hip arthroplasty: stabilization of the host-graft junction with tension band fixation.

Abstract

Large deficiencies of the metaphysis and proximal diaphysis present a significant challenge to the orthopaedic surgeon undertaking revision of failed total hip arthroplasty. Proximal femoral allograft-prosthetic reconstruction may enable revision in such situations. Secure fixation is essential to successful integration and function of these allograft-prosthetic constructs. We report our experience in 7 revision total hip arthroplasties in 5 patients. Proximal femoral allograft-prosthetic reconstruction was undertaken on all 7 hips using a technique of tension band fixation for securely fixing allograft to host bone at their interface to further minimize motion at the junction site and maximize union. Radiographic evidence of union at the interface was noted in 6 of 7 hips. Mean Harris hip score increased from 18 preoperatively to 83 postoperatively, with a mean follow-up of 78 months (range, 56-116 months).