[Massive reconstruction of the acetabulum and proximal femur]

Bone allografts are used in situations of repeated hip surgery to repair bone loss and allow muscle fixation without excessive use of massive metallic prostheses. We examined 51 cases of hip reconstruction after a mean follow-up of 3 and a half years. Indications were: reoperations on arthroplasties, usually after the weight carrying areas of the acetabulum had been destroyed; repeated operations on the upper extremity pellucid femurs; bone tumours (especially chondrosarcomas). Results have been good based on patient satisfaction, mobility and consolidation of the allograft-bone junction. Complications included: post-operative death after major surgery for invasive tumours (n = 4); sepsis (n = 2); hip luxation requiring an anti-luxation crescent (n = 3); and aseptic serous effusion suggestive of possible immunologic reactions against the bone grafts (n = 3). These operations were compared with massive reconstruction prostheses, with arthrodeses with limb shortening and with hanging limbs, and in certain cases with interilioabdominal amputations.