COMPLICATIONS OF PROXIMAL FEMORAL ALLOGRAFTS IN REVISION TOTAL HIP-ARTHROPLASTY

Four revision hip arthroplasties using a well-described surgical const ruct involving a large frozen femoral allograft to replace a deficient proximal femur developed six major complications related to the use o f the allograft or of the surgical construct. These cases represent th ree consecutive cases using this surgical construct performed by the s enior author and one postoperative referral that used the same constru ct. The complications included three allograft fractures, two nonunion s at the host-allograft junction, and one postoperative infection. All four of the patients previously had cemented revisions before the all ograft procedure, and all had deficient proximal femurs at the time of the allograft procedure. All three of the fractures occurred at the t ip of the femoral prosthesis within the allograft. The unacceptably hi gh fracture rate, three of four, was associated with the allograft fun ctioning as an unsupported load-bearing element in this study.