Impaction grafting: doing it right

Impaction grafting has emerged as a useful technique in the armamentarium of the revision total hip arthroplasty surgeon. The original technique proposed by Ling has been associated with complications, including femoral shaft fractures, recurrent dislocations, and uncontrolled component subsidence. Modifications in that technique seem to be associated with a reduction in complications. The radial impaction grafting technique permits the use of revision femoral components with variable stem lengths, neck lengths, and neck offsets. The technique seeks to improve the quality of bone impaction and reduce the incidence of subsidence. Initial results have been encouraging.