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Related Experiment Video

Updated: May 30, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Acetabular impaction grafting in total hip replacement.

Michael Rigby1, Paddy J Kenny, Rob Sharp

  • 1Great Western Hospital, Swindon, UK.

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|August 6, 2011
PubMed
Summary

Acetabular impaction grafting shows good survivorship, but large defects pose challenges. Revision cases often involved complex reconstructions, leading to technique modifications using larger bone chips and porous implants.

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Area of Science:

  • Orthopedic surgery
  • Bone allografting
  • Revision hip arthroplasty

Background:

  • Acetabular impaction grafting is effective but its use in large defects is debated.
  • This study evaluates a large cohort to identify limitations.

Purpose of the Study:

  • Assess the survivorship of acetabular impaction grafting.
  • Identify failure mechanisms, especially in larger acetabular defects.

Main Methods:

  • A consecutive series of 339 acetabular impaction grafting cases were analyzed.
  • Kaplan-Meier survival analysis was performed.
  • Mechanisms of early failure were investigated.

Main Results:

  • Overall survival was 89.1% at 5.8 years; aseptic loosening survival was 91.6%.

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  • Failures were linked to large rim mesh reconstructions, fractured plates, and migrating cages.
  • Nine of 15 revisions involved large rim mesh reconstructions.

    • Conclusions:

    • Impaction grafting results were disappointing for large rim mesh or significant reconstructions.
    • Technique modified to use larger cancellous bone chips (8-10 mm3) and larger cups.
    • Increased use of porous in-growth implants and bulk allografts with cages for extensive defects.