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![Page 1: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/1.jpg)
The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip
by Allan E. Gross, Hugh Blackley, Paul Wong, Khaled Saleh, and Ian Woodgate
J Bone Joint Surg AmVolume 84(4):655-667
April 1, 2002
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/2.jpg)
Drawing showing a contained (cavitary) acetabular defect.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/3.jpg)
Radiograph of a thirty-year-old man with a superomedial contained defect, made ten years after a hemiarthroplasty for the treatment of avascular necrosis of the femoral head.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/4.jpg)
Radiograph made 11.5 years after revision surgery with use of morselized allograft bone and an uncemented cup.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/5.jpg)
Radiograph of a sixty-year-old woman with a contained defect, made several years after a hemiarthroplasty for the treatment of a fracture of the right hip.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/6.jpg)
Radiograph made five years after revision surgery with a roof reinforcement ring and morselized allograft bone.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/7.jpg)
Drawing showing an uncontained defect involving <50% of the acetabulum.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/8.jpg)
The structural allograft (shelf or minor column), which is fixed by cancellous screws, supports <50% of the cup.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/9.jpg)
Radiograph of a thirty-two-year-old woman who had a bipolar arthroplasty because of hip dysplasia and osteoarthritis, showing the poor coverage of the bipolar cup.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/10.jpg)
Radiograph made fourteen years after revision surgery with a minor column (shelf) allograft and an uncemented cup.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/11.jpg)
Drawing showing an uncontained defect involving >50% of the acetabulum and pelvic discontinuity.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 12: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/12.jpg)
The hip is reconstructed with a structural allograft that is fixed with two cancellous screws and protected by a reconstruction ring that is fixed to the ilium and the ischium.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 13: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/13.jpg)
Radiograph of the pelvis of a seventy-seven-year-old man with a loose cemented cup and massive osteolysis of the right acetabulum involving >50% of the acetabulum and pelvic
discontinuity.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 14: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/14.jpg)
Radiograph made five years after reconstruction with a major column allograft protected by a reconstruction ring that extended from host ilium to host ischium.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 15: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/15.jpg)
A proximal femoral allograft with an implant cemented into the allograft. .
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 16: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/16.jpg)
A proximal femoral allograft-implant composite is inserted into the host canal without cement.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 17: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/17.jpg)
Radiograph of a sixty-six-year-old woman with a periprosthetic fracture and loss of proximal femoral bone stock.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 18: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/18.jpg)
The femur was reconstructed with a proximal femoral allograft.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 19: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/19.jpg)
Drawing of a cortical strut allograft held by cerclage wires over a noncircumferential cortical defect.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 20: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/20.jpg)
Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 21: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/21.jpg)
Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 22: The Use of Allografts in Orthopaedic Surgery - Part II: The Role of Allografts in Revision Arthroplasty of the Hip by Allan E. Gross, Hugh Blackley, Paul.](https://reader035.fdocuments.us/reader035/viewer/2022081512/5697c0311a28abf838cdb147/html5/thumbnails/22.jpg)
Figs. 6-B, 6-C, and 6-D Radiographs of the hip of a forty-five-year-old woman with avascular necrosis after failed internal fixation of a subcapital fracture.
Allan E. Gross et al. J Bone Joint Surg Am 2002;84:655-667
©2002 by The Journal of Bone and Joint Surgery, Inc.