Revision total hip arthroplasty with the use of structural acetabular allograft and reconstruction ring: a case series with a 10-year average follow-up

From 1980 through 1993, 20 consecutive massive structural acetabular allografts and reconstruction rings were performed in 19 patients. In all cases, the magnitude of the acetabular bone deficiency was such that the allograft supported >50% of the cup. The allograft was necessary to restore normal anatomy, bone stock, and leg length. Of the 19 patients who met the inclusion criteria, 7 subjects died of unrelated causes, and 3 subjects failed and underwent resection arthroplasty, 1 (8%) for graft resorption and 2 (15%) for recurrent dislocation. The remaining 9 patients (10 allografts) had a minimum follow-up of 5 years and average follow-up of 10.5 years. The cohort was analyzed using radiographic and outcome data collection questionnaires (AAOS/HKOD, WOMAC, SF-36). The study supports the use of massive structural allografts and reconstruction rings and achieves satisfactory results in 77% (10 of 13) of the patients. We believe these results reveal an impressive outcome for what used to be thought of as a salvage operation.