Femoral allograft reconstruction in revision total hip arthroplasty

Rigid graft fixation with cortical loading through the graft to protect from stress shielding is an important goal during femoral allograft reconstruction in revision total hip arthroplasty. Total proximal femur allografts require intramedullary prosthetic splinting and a step-cut osteotomy or extended lateral allograft plate for the most secure fixation and ultimate union. Nonunion and dislocation are the most critical complications, and infection rates are similar to other reconstruction procedures. This review discusses the principles and application of allografts in femoral revision total hip arthroplasty.