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Updated: Dec 1, 2025
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
High Incidence of Irradiated Cortical Strut Allograft Resorption Following Revision of Femoral Stems
Imran Ilyas1, Omar A Al-Mohrej2
1Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Background:
Despite the widespread use of revision total hip arthroplasties using cementless stems and cortical strut allografts, graft resorption has not been explicitly studied.
Methods:
Between 2010 and 2018, 40 femoral strut grafts were used in the revision of femoral stems of 36 patients (18 males and 18 females; average age, 51.9 ± 12.9 years). The mean follow-up was 78.9 ± 37.3 months. Failure was defined as revision surgery for any reason and subsidence of greater than 5 mm.
Results:
The survival rate of the stem without the need for revision at 5 years was 95% (mean graft survival time, 10.8 [95% CI, 9.414-12.234] years). Overall survival with graft resorption as the endpoint was 90% at 5 years (mean graft survival time, 8.8 [95% CI, 7.5-10.2] years). Survival with graft nonunion as the endpoint was 90% at 3 years (mean survival time, 11.7 [95% CI, 10.5-12.8] years).
Conclusion:
The resorption rate increases proportionally to the follow-up duration and can be very severe in a high percentage of cases. Long-term multicenter studies are required to assess the effect of resorption on prosthesis longevity.
