title: Femoral and acetabular revision using impacted nondemineralized freeze-dried bone allografts.
abstract: 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.
authors.affiliation: Department of Orthopaedics, Hospital de Clínicas de Porto Alegre (HCPA), University Hospital Tissue Bank, Rua Ramiro Barcelos 2350, 90035-003 Porto Alegre, RS, Brazil.
authors.forename: Carlos Roberto
authors.initials: CR
authors.lastname: Galia
authors.forename: Carlos Alberto de Souza
authors.initials: CA
authors.lastname: Macedo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Rosito
authors.forename: Lourdes Maria Araújo Quaresma
authors.initials: LM
authors.lastname: Camargo
authors.forename: Diane Ruschel
authors.initials: DR
authors.lastname: Marinho
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Moreira
mesh_terms: 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