Use of freeze-dried bone allografts in revision total hip arthroplasty

Abstract

Acetabular loosenings with severe bone loss require a large amount of graft material to fill the defect. Although all donors are systematically subjected to serologic screening, bone allografts that are chemically processed, freeze-dried, and radiosterilized ensure a higher level of microbiological safety than radiosterilised deep-frozen allografts. The bone allograft used in this study meets this requirement. Therefore, it was both interesting and important to evaluate its outcome in revision acetabuloplasty. This phase II multi-centre study involves 44 revision total hip replacements (35 evaluable) in patients with acetabular bone defects who received allografts obtained from femoral heads harvested from living donors. The results obtained at 40 months follow-up confirmed that reconstructions using a small amount of graft material have a satisfactory outcome. Where an allograft is used in association with an acetabular ring, good primary stability is provided by the ring and secondary stability is ensured by graft incorporation (which, in our study, has often shown to be enhanced by the use of bone cement). The advantages of this type of bone allograft are its greater ease of use and storage at room temperature.

Keywords: Acetabular reconstruction; Bone allograft; Revision total hip arthroplasty.