title: USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY.
abstract: To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures.
  
  
  METHODS
  A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical structural homologous bone graft and cemented implants, between June 1999 and February 2008. Of these, 21 fulfilled all the criteria required for this study. The patients underwent pre and postoperative clinical assessments using the Harris Hip Score. Preoperative, immediate postoperative and late postoperative radiographs were also evaluated, with comparisons of fracture consolidation, radiographic signs of graft consolidation, changes to the bone stock and femoral bone quality, and femoral alignment.
  
  
  RESULTS
  Nine patients (42.9%) underwent femoral reconstruction following mechanical failure of total hip arthroplasty and 12 cases (57.1%) underwent femoral reconstruction following periprosthetic fracture. Regarding the postoperative clinical classification, the results were considered satisfactory in 85.7% of the cases and unsatisfactory in 14.3%. Radiographic signs of graft consolidation were seen in all cases. There was an increase in bone stock in 90.5% of the hip reconstructions, as measured by the cortical index. Furthermore, the changes to femoral bone quality were considered good in 66.7% of the cases.
  
  
  CONCLUSIONS
  The use of cortical structural homologous bone grafts for both femoral reconstructive surgery on total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, enabling satisfactory clinical and radiographic results.
authors.affiliation: Head of the Hip Surgery and Reconstruction Group and Head of Medical Residency in Orthopedics and Traumatology, Orthopedics Hospital of Passo Fundo (HO), Passo Fundo, RS.
authors.forename: Milton Valdomiro
authors.initials: MV
authors.lastname: Roos
authors.affiliation: Fellow of Hip Surgery, Orthopedics Hospital of Passo Fundo (HO), Passo Fundo, RS.
authors.forename: Bruno Dutra
authors.initials: BD
authors.lastname: Roos
authors.affiliation: Medical Resident in Orthopedics and Traumatology, Orthopedics Hospital of Passo Fundo (HO), Passo Fundo, RS.
authors.forename: Taís Stedile Busin
authors.initials: TS
authors.lastname: Giora
authors.affiliation: Medical Resident in Orthopedics and Traumatology, Orthopedics Hospital of Passo Fundo (HO), Passo Fundo, RS.
authors.forename: Thiago Martins
authors.initials: TM
authors.lastname: Taglietti
keywords: Arthroplasty, hip/methods; Bone Transplantation; Femoral Fractures; Hip Prosthesis