Long-term results of allograft composite total hip prostheses for XXXX .

@entity1 @entity281 @entity85 @entity5
The functional results of standard reconstruction prostheses are impaired by instability because of poor muscular reinsertion, especially of the gluteal muscles. In 21 @entity1 , composite hip prostheses including proximal femoral allografts were used after primary @entity5 resection. Ten reconstructions used combined bone-tendon allografts that allowed reinsertion of the gluteal muscles to the allograft tendons. None of the 21 @entity1 had dislocation or @entity281 . Ten @entity1 died within 2 years of surgery without complications requiring reoperations. The mean followup in the 11 other @entity1 was 10 years. Eight @entity1 had reoperation: four for loosening (two at 3 years, two at 11 and 12 years), and four had autologous graftings for nonunion of the trochanter or of the distal graft-bone interface. Evaluation of function in the 11 @entity1 with follow-ups ranging from 4 to 15 years showed an average @entity85 Society score of 77%. Satisfactory strength of the abductor muscles was achieved by reinsertion of the trochanter or by suture of the @entity1 gluteal muscles with the combined tendon-bone allograft. At long-term, radiologically, the bony allograft showed no change in five @entity1 , very mild resorption in five, and severe resorption in one. Stem fixation was excellent in 10 @entity1 and fair in one. Comparison between the functional results of reconstruction prostheses versus composite prostheses showed a significant improvement with the composite prosthesis. In the authors' institution, at 10 years, the mechanical survival of composite prostheses was 81%, as compared with only 65% for reconstruction prostheses.
