抄録
From 1983 we began to use femoral head allografts in reconstructive surgery for failed total hip arthroplasties. All allograf is were taken from a patient who had undergone primary total hip arthroplasty. They were stored at -80° following Mankin's procedure.
Allograft reconstruction was done on 68 joints of 65 cases (6 males and 59 females) with a severely deficient acetabulum for a minimum period of 12 months. The average age at revision was 62.3, ranging from 34 to 84, and the average follow-up period in this series was 39.8 months. All procedures were performed with bone cement and reinforced by a metal device. The bone incorporation between allograf is and hosts were evaluated not only with an X-ray A-P view but with Tc -MDP bone scintigraphy.
Radiological assessment showed that bone union of the allograf t improved gradually within 2 years after operation. Results were excellent in 36 joints, good in 13 joints, fair in 2 joints and poor in 1 joint at the time of the 2-year follow-up. Two of the three fair or poor cases had an asymptomatic radiolucent line between allograf t and bone cement. The other case (fair) was suspected of having a mild deep infection. No collapse of allografts was seen in this series.
The conventional scintigraphic findings were that the uptake of radionuclide at the grafted lesion was sharply high initially with a ringlet and the grafted lesion became homogenous by 6 months after operation. The uptake of radionuclide decreased gradually and finally became at a normal level within 2 years. In addition, radionuclide angiography showed that the perfusion of blood supply to the grafted bone was maintained continuously.
Clinical results were also excellent or good in all cases. Allograf t reconstruction is considered to be an acceptable procedure to restore the severely deficient acetabulum in revision total hip arthroplasty.
