CORTICAL BONE ALLOGRAFTS IN TOTAL HIP REPLACEMENT

Abstract

Purpose: To assess the use of cortical allografts (bone plates?) in hip replacement surgery.

Materials and methods: This is a retrospective study of 43 bone plates in 36 hip prostheses. In 18 cases they were implanted to treat a periprosthetic fracture (an associated replacement of the femoral component was performed in 5 cases) and in 18 they were implanted to replace a loosened stem in a hip with large bone defects. Standard long uncemented stems were implanted in 7 cases and standard cemented stems associated with morselized compacted allografts were implanted in 16 cases. 14 patients were only given bone plates and in 22 these bone plates were associated to a metal plate. The mean age was 69.1 years (range: 38–82). 61.1% were female, 18% were implanted in the right side and the mean follow-up was 45.4 months.

Results: At the time of the last review, three patients had died but for reasons not related to their hip surgery. Transient sciatic nerve palsy was observed in one patient, prosthetic dislocation in three cases (two of them were successfully treated with bracing and the other had to be given a constrained cup), there was an infection (treated with a two-stage replacement) and two re-fractures (after 3 and 13 months) treated with a new osteosynthesis with a bone plate associated to a metal plate. All the fractures healed and the imaging tests showed an integration of the bone plate with the host bone with no signs of prosthetic loosening.

Conclusions: Cortical allografts can fulfill two functions: a mechanical one (they behave as if they were a plate) and a biological one (they increase bone stock on integration).