Cemented revision hip arthroplasty using strut and impacted cancellous allografts

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Complex proximal femoral defects pose challenges in revision hip arthroplasty.
• High mechanical failure rates are associated with traditional bone grafting methods.

Purpose of the Study:

• To evaluate the efficacy of combined cortical strut and impacted cancellous allografts in reducing mechanical failure.
• To assess the midterm clinical and radiographic outcomes of this combined grafting technique.

Main Methods:

• A retrospective study of 24 patients (10 male, 14 female) undergoing revision hip arthroplasty with proximal segmental bone defects.
• Combined use of proximal onlay cortical strut grafts and impacted cancellous allografts.
• Minimum 5-year follow-up with clinical assessments including Harris Hip Score, visual analogue scale for pain and satisfaction, and WOMAC scores.

Main Results:

• Significant improvement in Harris Hip Score from 26 to 83 points.
• High patient satisfaction (mean 8.7/10) and pain relief (mean 8.4/10).
• Low mechanical failure rate (4% aseptic loosening), with all allografts successfully incorporated.

Conclusions:

• The combination of proximal cortical strut and impacted cancellous allografts is effective for treating proximal femoral defects.
• This technique demonstrates acceptable midterm results with a low revision rate for mechanical failure.
• Successful allograft incorporation suggests good biological integration and bone stock restoration.