The role of allografts in revision arthroplasty of the hip.

The role of allograft tissue, including bone, cartilage and soft tissue, has become more defined in lower extremity reconstructive surgery. Revision arthroplasty of the hip commonly requires restoration of bone stock using allograft bone. Morcellized bone is used for contained defects on both the acetabular and femoral sides. Structural allograft bone is used for uncontained or segmental defects, and the results are less predictable; therefore, its use is more controversial. Alternatives include the jumbo cup, oblong cup, and high hip center on the pelvic side and tumor prostheses or distal fixation on the femoral side. These alternatives do not, however, restore bone stock, thus making further surgery more difficult. Structural grafts allow attachment of bone and soft tissue and restoration of the correct anatomy and have been shown to restore bone stock for further surgery, particularly on the acetabular side. Improvements in the quality and safety of banked bone and the development of surgical techniques have enhanced the results of structural allograft bone grafting. Restoring bone stock in revision arthroplasty of the hip is an accepted standard for the patient likely to undergo further surgery. Continuing to develop technologies that will facilitate the use of allograft tissue is imperative.