Description:
<jats:sec><jats:title>Introduction</jats:title><jats:p>Femoral impaction bone allografting in revision hip arthroplasty facilitates physiological reconstruction with restoration of bone stock, allowing implantation of a standard cemented femoral component. The purpose of this study was to report our experience in femoral component revision arthroplasty with impaction morsellised cancellous bone allograft using custom impactors and a cemented triple-taper polished stem.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Retrospective analysis of all cases of femoral component revision hip arthroplasty with impaction bone grafting undertaken by a single surgeon from 2005 to 2011. Outcome measures included radiographic analysis of stem subsidence over time, graft remodelling and incorporation, and clinical progress.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We reviewed 47 consecutive hips in 44 patients, mean age 62 years (37-88). Femoral impaction with allograft was performed as either single stage (41 cases) or 2-stage (6 cases) procedures. All patients received a cemented C-stem prosthesis. The mean follow-up period was 5.1 (1.3-9.4) years. The median pre-operative bone defect score was 3 (interquartile range [IQR] 2-3) using the Endo-Klinik classification. Radiological evidence of graft incorporation was observed in 89% (281 of 315 zones) with additional remodelling observed in 33% (103 of 315 zones). The median stem subsidence at 1-year follow-up was 1.1 mm (standard deviation [SD] 1.24 mm, range 0-6 mm). The median Oxford Hip Score at the most recent follow-up was 36.5. To date no femoral component has undergone further revision.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Encouraging results have been obtained with this technique for the treatment of significant bone loss in revision hip arthroplasty, allowing implantation of a standard prosthesis.</jats:p></jats:sec>