To analyze the clinical and radiographic results after revision total knee arthroplasty using a structural allograft for large bone defects.

184 cases of revision total knee arthroplasty were performed from January 1992 to February 2003. Among them, 52 knees in 48 patients with the use of structural allograft for the management of large bone defects were retrospectively reviewed. Those 52 knees have been followed until recently. The average follow-up period was 5 years and 6 months. Fresh-frozen femoral head was used as the structural allograft in all knees. The clinical rating system of the American Knee Society was used for the clinical assessment. Union at the allograft-host bone junction, femoro-tibial angle and periprosthetic radiolucent lines using a radiographic evaluation of American Knee Society were analyzed radiographically.

At the final follow-up, the mean preoperative knee and function score improved from 38.6 points to 82.6 and 30.3 to 76.4, respectively. Radiographically, union of the allograft to the host bone was observed in all knees. The average femoro-tibial angle was corrected from 1.8 ° in valgus to 6.2 °. The radiographic evaluation revealed no evidence of loosening.

Revision total knee arthroplasty using a femoral head allograft is an appropriate surgical method for treating large bone defects.