Research Article: Proximal Femoral Allograft for Major Segmental Femoral Bone Loss: A Systematic Literature Review

Date Published: October 13, 2011

Publisher: SAGE-Hindawi Access to Research

Author(s): B. A. Rogers, A. Sternheim, D. Backstein, O. Safir, A. E. Gross.

http://doi.org/10.4061/2011/257572

Abstract

As the indications for total hip arthroplasty increase, the prevalence of extensive proximal femoral bone loss will increase as a consequence of massive osteolysis, stress shielding and multiple revisions. Proximal femoral bone stock deficiency provides a major challenge for revision hip arthroplasty and is likely to account for a significant future caseload. Various surgical techniques have been advocated included impaction allografting, distal press-fit fixation and massive endoprosthetic reconstruction. This review article provides a systematic review of the current literature to assess the outcome of revision hip arthroplasty using allograft to reconstruction massive proximal femoral bone loss.

Partial Text

As the need for total hip arthroplasty increases, the incidence of extensive proximal femoral bone loss will increase as a consequence of massive osteolysis, stress shielding and multiple revisions [1–5]. Proximal femoral bone stock deficiency provides a major challenge for revision hip arthroplasty and is likely to account for a significant future caseload [6].

A comprehensive search of the MEDLINE, EMBASE, and the National Institutes of Health online database PubMed from the earliest records to the time of review (January 2011) was performed. The following Medical Subject Headings (MeSH) terms were used: “allograft,” “composite graft” in the manuscript title, and “proximal femoral” in the manuscript abstract. The keywords were used as both text words and Medical Search Headings (MeSH terms).

The continued followup and analysis of this technique should be encouraged to refine and develop the management of massive proximal femoral bone loss. This review demonstrates that proximal femoral allografts for revision hip arthroplasty in femoral segmental bone loss do provide a durable solution, with current available evidence reporting a survivorship of 80%. Whilst a range of surgical techniques have been described, this study highlights the following:

 

Source:

http://doi.org/10.4061/2011/257572

 

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