Femoral and acetabular revision using impacted nondemineralized freeze-dried bone allografts.
BACKGROUND
Favorable results have been obtained by the use of deep-frozen bone allografts in total hip arthroplasty. However, owing to the shortage of deep-frozen allografts and the risk of infectious disease, other materials have been studied, such as sterile nondemineralized freeze-dried allografts. The aim of this study was to describe midterm clinical outcomes and radiographic bone incorporation of human freeze-dried bone grafts in 42 revision total hip arthroplasty procedures using cancellous impacted bone grafting.


METHODS
This report presented clinical and radiographic evidence of allograft incorporation in 42 hip reconstructions performed between 1996 and 2002. The patient group included 13 (31%) men and 29 (69%) women with mean +/- SD age of 63 +/- 14 years (range 28-80 years). Mean follow-up was 82 months (range 63-127) months. Clinical analysis was based on the D'Aubigné-Postel score. Radiographic incorporation was defined according to specific criteria.


RESULTS
The D'Aubigné and Postel criteria showed adequate outcome in 38 (90%) of the patients. The radiographic evaluation revealed that allograft remodeling and incorporation were found in 39 (93.0%) and 36 (86.5%) of acetabular and femoral cases, respectively. The overall graft survival rate at an average follow-up of 8 years (range 5-10 years) was 90%.


CONCLUSIONS
Bone grafts obtained by the lyophilization process developed and carried out in our tissue bank provide suitable grafts for revision total hip arthroplasty. Clinical and radiographic midterm results were excellent, indicating that nondemineralized freeze-dried bone allografts are suitable for replacing deep-frozen grafts.
Galia
Carlos Roberto
CR
Department of Orthopaedics, Hospital de Clínicas de Porto Alegre (HCPA), University Hospital Tissue Bank, Rua Ramiro Barcelos 2350, 90035-003 Porto Alegre, RS, Brazil.
Macedo
Carlos Alberto de Souza
CA
Rosito
Ricardo
R
Camargo
Lourdes Maria Araújo Quaresma
LM
Marinho
Diane Ruschel
DR
Moreira
Luis Fernando
LF
D000077:Acetabulum / Q000637:transplantation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005269:Femur / Q000637:transplantation; D005500:Follow-Up Studies; D005612:Freeze Drying; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods