Autobanking of femoral heads for revision total hip replacement, a preliminary report of a new surgical technique.
OBJECTIVE
Conventional banking of bone allografts has been well documented in the literature. It relies on standardised screening and providing a sterile storage facility. We report a new surgical technique of banking the femoral head in a surgically fashioned subperiosteal iliac pouch and its use for the donor's own surgery.


METHODS
Thirteen patients with an average age of 60 years and a diagnosis of osteoarthritis of the hip with a contralateral symptomatic loose hip replacement were selected. The femoral head was harvested and banked. On retrieval, histological analysis was performed in four specimens with clinical and radiographic review of all subjects.


RESULTS
Radiographic results show good integration of the morselised femoral head bone graft in revision hip surgery. Histological results from four retrieved specimens show viability at eight years and eleven months from insertion into the pouch.


CONCLUSIONS
Autobanking of the patient's own femoral head is suitable in a select group of patients in whom a combined primary and contralateral revision total hip replacement poses an unacceptable anaesthetic risk. It has the advantage of providing a graft with osteoinductive potential and a reduced risk of infection. It eliminates the need for a storage facility and screening programme. It also provides a portable storage facility if the patient moves elsewhere.
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The Institute of Orthopaedics, The Norfolk and Norwich University Hospital, UK. CaroH2712@aol.com
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D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D018586:Bone Banks; D005260:Female; D005270:Femur Head / Q000637:transplantation*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D020858:Tissue and Organ Harvesting; D014182:Transplantation, Autologous; D016896:Treatment Outcome