Massive early subsidence following femoral impaction grafting

The incidence of massive early subsidence (subsidence greater than 10 mm) following impaction grafting of the femur in revision surgery is reported. The first 79 consecutive revision total hip arthroplasties using morselized allograft, polymethyl methacrylate cement, and a double-tapered, polished, collarless stem were reviewed. Nine (11%) of the 79 revision femoral prostheses showed massive subsidence, with another nine hips subsiding to a lesser degree. Further elucidation of the critical factors contributing to the initial stability of the biologic composite is required.