Related Experiment Video
Updated: Nov 16, 2025
09:51
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
3.3K
Impaction bone grafting in hip re-revision surgery
Eduardo Garcia-Rey1,2, Laura Saldaña2,3, Eduardo Garcia-Cimbrelo1,2
1Orthopaedics Department, Hospital Universitario La Paz-Idi Paz, Madrid, Spain.
The Bone & Joint Journal
|March 1, 2021
Summary
Impaction bone grafting (IBG) effectively restores bone stock in revision hip surgery, even in re-revision cases. This technique helps reduce acetabular bone defects, though careful surgical technique is needed to minimize component migration.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Revision hip arthroplasty often involves significant acetabular bone defects.
- Impaction bone grafting (IBG) is a technique used to restore bone stock in these cases.
- The efficacy of repeated IBG in re-revision surgery is less understood.
Purpose of the Study:
- To evaluate the acetabular bone defect size during re-revision surgery following initial IBG.
- To analyze the clinical and radiological outcomes of re-revisions using repeated IBG.
- To assess the long-term survival of acetabular components after re-revision with IBG.
Main Methods:
- A retrospective review of 45 hips undergoing re-revision with IBG after aseptic loosening.
- Comparison of Paprosky defect grading between initial revision and re-revision surgeries.
- Analysis of clinical scores (Harris Hip Score) and radiological findings, including component migration.
- Survival analysis using competing risk analysis.
Main Results:
- A significant reduction in acetabular bone defect severity (Paprosky grading) was observed at re-revision compared to the initial revision (p=0.020).
- Mean Harris Hip Score improved from 45.4 preoperatively to 80.7 postoperatively.
- Twelve hips showed radiological migration, and three required further revision. Nine-year cumulative failure incidence was 9.6% for any cause.
Conclusions:
- Impaction bone grafting is effective for bone stock restoration in revision and re-revision hip arthroplasty.
- Repeated IBG can reduce acetabular bone defect size, facilitating acetabular component reconstruction.
- Optimizing surgical technique, particularly regarding the hip rotation center, is crucial to minimize radiological migration and improve long-term outcomes.
