[Massive reconstruction of acetabulum and proximal femur].

Abstract

In revision hip surgery, allografts are useful for restoring the bone stock and allow the muscle fixation avoiding the use of massive metallic prothesis. We have reviewed 51 hip reconstructions with a follow up of 4 years and half (1982 - 1991). Indications were: - revision arthroplasties with destroyed acetabulum, - bone tumors (mainly chondrosarcoma). The results are good for pain, articular movement and the consolidation of the allograft host bone junction. Some complications were encountered: - Post-operative death (early or late for tumoral extension) in case of major surgery for tumor (4 cases). - Deep infections (2 cases). - Weakness of the gluteus medius with hip dislocation needing anti-dislocation device. - Aseptic serous fluid leak meaning immunobiologic reaction of bone grafts (3 cases). This surgery has to be compared to massive reconstruction prostheses, arthrodesis with limb shortening, femoral head and neck resection and in some cases inter ilio-abdominal amputation which gives also major post-operative complication.