Bone allografts in salvage of difficult hip arthroplasties

Fourteen bone allograft transplantations were performed in 12 patients: five whole-hip osteoarticular allografts, eight acetabular wall, and one proximal femur with long-stem prosthesis. Average followup time was 19 months. Average patient age was 46 years. Acetabular grafts appeared healed. There was narrowing of joint space in all whole-hip allografts. However, joint narrowing did not correlate with functional results. Failures were attributed to collapse of the femoral head in one patient and nonunion at the host-allograft junction in two patients. However, even in primary failures, allografts provided bone stock to substitute for massive bone loss; this allowed for further reconstruction with endoprostheses. Intercalary segmental allografts combined with prosthetic devices gave the best results.