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The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.

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Presentation on theme: "The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul."— Presentation transcript:

1 The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul Wong, Khaled Saleh, and Ian Woodgate J Bone Joint Surg Am Volume 84(4):655-667 April 1, 2002 ©2002 by The Journal of Bone and Joint Surgery, Inc.

2 Drawing showing a contained (cavitary) acetabular defect. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

3 Radiograph of a thirty-year-old man with a superomedial contained defect, made ten years after a hemiarthroplasty for the treatment of avascular necrosis of the femoral head. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

4 Radiograph made 11.5 years after revision surgery with use of morselized allograft bone and an uncemented cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

5 Radiograph of a sixty-year-old woman with a contained defect, made several years after a hemiarthroplasty for the treatment of a fracture of the right hip. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

6 Radiograph made five years after revision surgery with a roof reinforcement ring and morselized allograft bone. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

7 Drawing showing an uncontained defect involving <50% of the acetabulum. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

8 The structural allograft (shelf or minor column), which is fixed by cancellous screws, supports <50% of the cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

9 Radiograph of a thirty-two-year-old woman who had a bipolar arthroplasty because of hip dysplasia and osteoarthritis, showing the poor coverage of the bipolar cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

10 Radiograph made fourteen years after revision surgery with a minor column (shelf) allograft and an uncemented cup. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

11 Drawing showing an uncontained defect involving >50% of the acetabulum and pelvic discontinuity. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

12 The hip is reconstructed with a structural allograft that is fixed with two cancellous screws and protected by a reconstruction ring that is fixed to the ilium and the ischium. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

13 Radiograph of the pelvis of a seventy-seven-year-old man with a loose cemented cup and massive osteolysis of the right acetabulum involving >50% of the acetabulum and pelvic discontinuity. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

14 Radiograph made five years after reconstruction with a major column allograft protected by a reconstruction ring that extended from host ilium to host ischium. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

15 A proximal femoral allograft with an implant cemented into the allograft.. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

16 A proximal femoral allograft-implant composite is inserted into the host canal without cement. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

17 Radiograph of a sixty-six-year-old woman with a periprosthetic fracture and loss of proximal femoral bone stock. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

18 The femur was reconstructed with a proximal femoral allograft. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

19 Drawing of a cortical strut allograft held by cerclage wires over a noncircumferential cortical defect. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

20 Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

21 Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.

22 Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture. Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667 ©2002 by The Journal of Bone and Joint Surgery, Inc.


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