The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.

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Presentation transcript:

The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul Wong, Khaled Saleh, and Ian Woodgate J Bone Joint Surg Am Volume 84(4): April 1, 2002 ©2002 by The Journal of Bone and Joint Surgery, Inc.

Drawing showing a contained (cavitary) acetabular defect. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph of a thirty-year-old man with a superomedial contained defect, made ten years after a hemiarthroplasty for the treatment of avascular necrosis of the femoral head. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph made 11.5 years after revision surgery with use of morselized allograft bone and an uncemented cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph of a sixty-year-old woman with a contained defect, made several years after a hemiarthroplasty for the treatment of a fracture of the right hip. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph made five years after revision surgery with a roof reinforcement ring and morselized allograft bone. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Drawing showing an uncontained defect involving <50% of the acetabulum. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

The structural allograft (shelf or minor column), which is fixed by cancellous screws, supports <50% of the cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph of a thirty-two-year-old woman who had a bipolar arthroplasty because of hip dysplasia and osteoarthritis, showing the poor coverage of the bipolar cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph made fourteen years after revision surgery with a minor column (shelf) allograft and an uncemented cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Drawing showing an uncontained defect involving >50% of the acetabulum and pelvic discontinuity. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

The hip is reconstructed with a structural allograft that is fixed with two cancellous screws and protected by a reconstruction ring that is fixed to the ilium and the ischium. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph of the pelvis of a seventy-seven-year-old man with a loose cemented cup and massive osteolysis of the right acetabulum involving >50% of the acetabulum and pelvic discontinuity. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph made five years after reconstruction with a major column allograft protected by a reconstruction ring that extended from host ilium to host ischium. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

A proximal femoral allograft with an implant cemented into the allograft.. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

A proximal femoral allograft-implant composite is inserted into the host canal without cement. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Radiograph of a sixty-six-year-old woman with a periprosthetic fracture and loss of proximal femoral bone stock. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

The femur was reconstructed with a proximal femoral allograft. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Drawing of a cortical strut allograft held by cerclage wires over a noncircumferential cortical defect. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture. Allan E. Gross et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.