Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Femoral Bone Loss in Patients Managed with Revision Hip Replacement: Results.

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Presentation transcript:

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Femoral Bone Loss in Patients Managed with Revision Hip Replacement: Results of Circumferential Allograft Replacement*† by FARES S. HADDAD, DONALD S. GARBUZ, BASSAM A. MASRI, CLIVE P. DUNCAN, CAROL R. HUTCHISON, and ALLAN E. GROSS J Bone Joint Surg Am Volume 81(3): March 1, 1999 ©1999 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1-A, 1-B, and 1-C: Schematic illustrations of proximal femoral reconstruction with use of a structural allograft. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-B: The allograft-implant composite is inserted into the host femur with no cement distally or at the host-allograft junction. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-C: The greater trochanter and the host femur are wired to the allograft. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A and 2-B: Anteroposterior radiographs made before and after revision with use of a structural femoral allograft reinforced with strut allografts at the graft-host junction. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-B: Radiograph made 6.5 years after the operation. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A, 3-B, and 3-C: Radiographs made before and after revision with a structural femoral allograft. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-B Anteroposterior and lateral radiographs made six years postoperatively, showing wiring at the site of the step-cut osteotomy and union with florid callus formation. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-C Anteroposterior and lateral radiographs made six years postoperatively, showing wiring at the site of the step-cut osteotomy and union with florid callus formation. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4 Radiograph made nine years postoperatively, showing trochanteric union and union between the allograft and the residual proximal host femur. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5 Anteroposterior radiograph made four years postoperatively, showing severe resorption, down to the allograft-cement junction, in the absence of infection. FARES S. HADDAD et al. J Bone Joint Surg Am 1999;81: ©1999 by The Journal of Bone and Joint Surgery, Inc.