Wheeless' Textbook of Orthopaedics
C.R. Wheeless MD
Wheeless' Textbook of Orthopaedics
total hip arthroplasty.
Chandler H. Clark J. Murphy S. McCarthy J. Penenberg B. Danylchuk K.
Clinical Orthopaedics & Related Research. (298):67-74, 1994 Jan.
Reconstruction of major proximal femoral segmental defects is one of the
most difficult challenges in revision total hip arthroplasty (THA). One
technique that has been successful is the use of a modular, long-stemmed Á
prosthesis, cemented to an allograft proximal femur and press-fit to the Â
host bone. Since July 1989, the authors have used this technique in 30
hips (29 patients). The trochanteric slide approach was used in all cases.
Sixty pounds of weight bearing was encouraged for six weeks, then full
weight bearing as tolerated. The mean follow-up period was 22 months
(range, two to 46 months). All but two grafts united to the host bone
clinically and radiographically. Complications included five dislocations,
one graft-host nonunion, one graft resorption, and one deep infection
requiring resection arthroplasty. The latter patient was subsequently
reconstructed successfully using the same technique. Although the
follow-up period is short, the authors have been encouraged by the early
success of these allograft-prosthetic composites. Advantages of this
approach include rapid return to weight bearing, physiologic loading of
the distal femur, and reconstitution of vital proximal bone stock. *
total hip arthroplasty.
Chandler H. Clark J. Murphy S. McCarthy J. Penenberg B. Danylchuk K.
Clinical Orthopaedics & Related Research. (298):67-74, 1994 Jan.
Reconstruction of major proximal femoral segmental defects is one of the
most difficult challenges in revision total hip arthroplasty (THA). One
technique that has been successful is the use of a modular, long-stemmed Á
prosthesis, cemented to an allograft proximal femur and press-fit to the Â
host bone. Since July 1989, the authors have used this technique in 30
hips (29 patients). The trochanteric slide approach was used in all cases.
Sixty pounds of weight bearing was encouraged for six weeks, then full
weight bearing as tolerated. The mean follow-up period was 22 months
(range, two to 46 months). All but two grafts united to the host bone
clinically and radiographically. Complications included five dislocations,
one graft-host nonunion, one graft resorption, and one deep infection
requiring resection arthroplasty. The latter patient was subsequently
reconstructed successfully using the same technique. Although the
follow-up period is short, the authors have been encouraged by the early
success of these allograft-prosthetic composites. Advantages of this
approach include rapid return to weight bearing, physiologic loading of
the distal femur, and reconstitution of vital proximal bone stock. *