Revision total hip arthroplasty using an interlocking stem with an allograft-prosthesis composite

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• Revision hip arthroplasty is challenging, especially with massive proximal femur bone deficiency.
• Allograft-prosthesis composites (APCs) offer a solution for bone reconstruction in complex cases.
• Cementless interlocking stems provide stable fixation in compromised bone stock.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of revision hip surgery using a cementless interlocking stem with an APC.
• To assess complications associated with this reconstructive technique.
• To determine the efficacy of APCs in addressing severe proximal femur bone loss during revision arthroplasty.

Main Methods:

• Retrospective review of 11 patients undergoing revision hip surgery with a cementless interlocking stem and APC.
• Average follow-up of 73 years.
• Clinical assessment using Harris hip score and radiographic evaluation of osseous union and allograft resorption.

Main Results:

• Mean Harris hip score improved significantly from 25.6 to 74.8.
• Osseous union at the allograft-host junction occurred in 90.9% of hips.
• Complications included 1 deep infection, 2 heterotopic ossifications, and 1 dislocation; 57.1% of greater trochanters did not unite.

Conclusions:

• Revision surgery with a cementless interlocking stem and APC yields acceptable clinical and radiographic results for massive proximal femur bone deficiency.
• The technique demonstrates good osseous integration at the allograft-host junction.
• While effective, potential complications such as non-union of the greater trochanter and resorption require consideration.