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Impacted cancellous graft plus cement in hip revision
Miguel E Cabanela1, Robert T Trousdale, Daniel J Berry
1Maypo Clinic, 200 First Street SW, Rochester, MN 55905, USA. cabanela.miguel@mayo.edu
Clinical Orthopaedics and Related Research
|December 4, 2003
Summary
Impaction cancellous grafting effectively restores bone stock for complex femoral revisions. This technique, combined with specific prostheses and allografts, yielded excellent long-term results with minimal loosening, though fractures remain a concern.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Femoral component revision is challenging with large cavitary defects.
- Impaction cancellous grafting is a recommended technique for bone stock restoration.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of femoral revision using impaction grafting.
- To assess the efficacy and complications of this technique in restoring bone stock.
Main Methods:
- Fifty-seven femoral revisions were performed between 1993-1997 using impaction grafting and a collarless, tapered, polished stem.
- Strut allografts were utilized for femoral reinforcement in 40 hips.
- Follow-up averaged 6.3 years.
Main Results:
- Excellent clinical results were observed after 6.3 years.
- No prosthetic loosening was detected in surviving hips; minimal subsidence (1-6 mm) was noted.
- Cancellous remodeling occurred in 42 hips.
Conclusions:
- Impaction grafting provides excellent and durable results for femoral revisions.
- Postoperative femoral fractures, though treatable, represent the most significant complication.
- Meticulous surgical technique is crucial for successful outcomes.