Proximal femoral allografts in revision total hip arthroplasty

Patients with total hip arthroplasty (THA) and aseptic loosening associated with severe bone deficiency were treated with freeze-dried bone allografts of the proximal one-third of the femur. Twenty-two of the first 25 patients were available for review with an average follow-up period of 28 months. Significant functional improvement was obtained in 16 patients (73%). The following complications occurred with allograft revisions: dislocation, wound hematoma, joint instability, nonunion, implant failure, and acetabular loosening. Nine patients required additional surgical procedures. There have been no infections or rapid lysis indicative of an allograft rejection phenomenon. The 73% success at the two-year postoperative interval of incorporation of freeze-dried allografts for salvage situations has been encouraging. However, the long-term durability of these grafts is not known and will require further follow-up study.