Onlay cortical strut grafting in revision arthroplasty of the hip

Cortical strut allografts are used to restore uncontained noncircumferential femoral defects, to bypass stress risers, to stabilize proximal femoral allograft host junctions, and to fix periprosthetic fractures. These struts can be made from hemicylinders of diaphyseal bone or from fibulae. They are fixed to host bone by circumferential wires. If autograft bone is available, it is placed between the strut and host, particularly at the ends of the strut. A radiographic study of 52 cortical strut allografts with an average follow-up of 4.8 years revealed 2 nonunions and 2 progressive resorptions. All other struts united with minimal resorption.