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Published on: September 7, 2022
Revision total hip arthroplasty with femoral impaction bone grafting
Chun Hoi Yan1, Kwong Yuen Chiu, Tsz Pui Ng
1Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong. yanchoi@hku.hk
Insights
Revision total hip arthroplasty (THA) using femoral impaction bone grafting (IBG) shows good medium-term results. This safe procedure in selected patients improved hip function and reduced pain.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Revision total hip arthroplasty (THA) is complex, often requiring bone reconstruction.
- Femoral impaction bone grafting (IBG) is a technique used to address bone loss in THA revisions.
Purpose of the Study:
- To evaluate the radiological and clinical outcomes of revision THA utilizing femoral IBG.
- To assess the safety and efficacy of IBG in complex hip reconstructions.
Main Methods:
- Retrospective review of 15 revision THA cases using femoral IBG with Elite plus stems.
- Patients were treated for aseptic loosening or infection, with a mean age of 61 years.
- Radiological and clinical assessments included Harris hip scores and subsidence measurements.
Main Results:
- Mean follow-up was 7.7 years, with significant improvement in Harris hip scores (61.7 to 83.7).
- 11 out of 15 hips reported no pain. Mean subsidence was 5.7 mm, and mean alignment change was 1.2 degrees.
- No radiological stem loosening was observed; one case of peri-prosthetic fracture occurred. Cortical healing and trabecular incorporation were noted in most cases.
Conclusions:
- Femoral IBG is a safe and effective technique for revision THA in carefully selected patients.
- The procedure yields good medium-term clinical and radiological results, despite potential complications.
- IBG facilitates bone consolidation and stem stability in revision hip arthroplasty.
Purpose:
To report the radiological and clinical results of revision total hip arthroplasty (THA) with femoral impaction bone grafting (IBG).
Methods:
4 men and 9 women (15 hips) aged 38 to 84 years underwent revision THA with femoral IBG using Elite plus stems for aseptic loosening or infection.
Results:
The mean follow-up duration was 7.7 years. The Harris hip score improved from 61.7 to 83.7. There was no pain in 11 hips and slight pain in 4. The mean subsidence was 5.7 mm. The mean change of alignment was 1.2 degrees. There was no radiological evidence of stem loosening. One stem was revised due to a peri-prosthetic fracture. Cortical healing was noted in 11 hips, and trabecular incorporation in 10.
Conclusion:
Although intra- and post-operative complications were not uncommon, femoral IBG is a safe procedure in carefully selected patients and offers good medium-term results.