Structural bone grafting for femoral reconstruction.

Structural grafting for femoral reconstruction has been used in femoral revision surgery in connection with partial bone loss. In patients in whom the proximal femur is compromised significantly circumferentially, or is entirely absent, segmental proximal femoral allografts are indicated. Onlay cortical allografts have been used to supplement bone stock when the intact femur has advanced noncircumferential deficiencies attributable to osteoporosis, osteolysis, or other causes. The procedure using proximal femoral allografts was performed in 262 patients from 1983 to 1997. Satisfactory results were obtained in 85% of the patients. More than 1000 cortical onlay bone plate allografts were performed from 1984 to 1997. Detailed information was obtained on 251 patients who underwent surgery from 1984 to 1990. These constructs reliably united with the host bone and increased bone mass long-term.