Proximal femoral allografts in revision total hip arthroplasty

The senior authors have performed 141 proximal femoral whole-bone allografts in failed total hip reconstruction. The results of the first 50 have been previously reported. This study reviews 70 additional cases performed since 1987 and reflects improved technique and several different junctional constructs. Modest improvements in the rate of union (64% v 80%) and of dislocation (28% v 16%) have been achieved. The infection rate (6% v 4%) and demographics of the groups have remained constant. The frequency of complications (67% v 53%) has decreased, but unfortunately remains high. A step-out allograft junction with a long lateral sleeve has been the most reliable construct.