Cortical Strut Allografts for the Treatment of Femoral Fractures and Deficiencies in Revision Total Hip Arthroplasty

ABSTRACT: Thirty-three hips had revision total hip arthroplasty, using an average of three  cortical strut allografts fixed to the femur with cables and followed-up for a mean of 4 years.  The indications for strut allografts were ectatic femurs or segmental defects of the femoral  diaphysis (22 hips), femoral fractures (10 hips), and severe proximal femoral osteolysis (1 hip).  Twenty-one hips had an excellent or good clinical result, 6 had a fair clinical result, and 6 had a  poor clinical result. Reoperation  was done in six hips, but in only two hips was reoperation  related to failure of the allograft. Nine of the 10 femoral fractures repaired with allograft struts  healed by 3 to 6 months. Radiographs showed partial or complete bridging of the allograft to  host bone with peripheral remodeling and minimal resorption in 30 of 33 hips. Strut allografts,  fixed with multiple cables,  are an important adjunct to femoral component revision  for the restoration of deficient femoral bone stock and in the treatment of  periprosthetic femur fractures.