Restoration of femoral bone stock in revision total hip arthroplasty.

The presence of femoral deficiencies in revision total hip arthroplasty may contribute to loosening, subsidence, and fracture. Between 1984 and 1990, 174 patients were treated with revision total hip arthroplasty, preformed by a standardized operative technique using cortical onlay strut allografts to restore the structural integrity of the femur and a calcar deficient proximally porous coated femoral prosthesis, composed of titanium alloy. The grafts united 98% of the time and showed evidence of revascularization and, in some cases, complete incorporation. Cortical onlay strut grafting in conjunction with a proximal load- bearing prosthesis is a viable method of reconstructing the structurally deficient femur in revision total hip arthroplasty.