Treatment of failed allograft prosthesis composites used for hip arthroplasty in the setting of severe proximal femoral bone defects.
This study assessed failures of allograft prosthesis composites (APC) and revisions with a new APC. Twenty-one patients with failed APC's after revision hip arthroplasty with severe proximal femoral bone loss underwent revision with a new APC. Causes of failure were aseptic loosening (18 patients), infection (3 patients). Of these 21 APC revisions, two patients failed (after 60, 156 months). The 5 and 10 year survival rates were 83.5% (95% CI, 79-100%, number at risk 12 and 6 accordingly). In addition, two patients had non-union at the host-allograft bone junction and were augmented with bone autograft and plate. These results suggest that failed APCs may be revised to a new APC with a predictable outcome.
Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Amir
A
Sternheim
Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Michael
M
Drexler
Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Paul R
PR
Kuzyk
Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Oleg A
OA
Safir
Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
David J
DJ
Backstein
Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Allan E
AE
Gross
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001862:Bone Resorption; D016025:Bone Transplantation; D005260:Female; D005269:Femur / Q000601:surgery; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D014184:Transplantation, Homologous; D016896:Treatment Outcome
allograft prosthesis composite; major segmental bone loss proximal femur; revision hip replacement