One hundred thirteen cases of cementless femoral revision total hip arthroplasty using either cortical strut or proximal calcar allografts were reviewed for radiographic incorporation at an average 4.75 years after operation. All cortical strut grafts were used to supplement the host bone after achieving stable femoral fixation by a tight distal diaphyseal fit. Eighty-seven of the 95 cortical strut grafts showed radiographic evidence of graft incorporation. Eleven of the 18 calcar grafts had resorbed. Complications consisted of eight dislocations, three pulmonary embolisms, two superficial infections, two myocardial infarctions, and two sciatic nerve palsies. When stable distal fixation of cementless femoral prostheses have been achieved, the cortical strut allograft can be readily incorporated into the host femur and augments the host bone structure.
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