title: Patch-grafting for regional femoral bone loss in cementless revision hip arthroplasty.
abstract: The authors reviewed 33 revision hip arthroplasties using the long-stemmed porous coated anatomic (PCA) prosthesis that required adjuvant patch-grafting for proximal defects of the femur. All hips were revised for aseptic loosening. The mean follow-up period was 3.7 years (2.0-5.8 years). The hips were clinically evaluated by means of the Harris Hip Score: 26 (79%) were found to be good or excellent, 3 (9%) fair and 4 (12%) poor. Graft incorporation occurred in 31/33 cases (94%). Proximal stress protection bone resorption was not seen, although cancellisation of the calcar was noted in 20/33 (60%) hips. Serial radiological review demonstrated some degree of subsidence of the femoral stem in 20/33 (60%) hips. The authors conclude that patch-grafting of the proximal femur at revision surgery incorporates and is not inhibited by the presence of a rigid long-stemmed implant.
authors.affiliation: Princess Margaret Hospital, Swindon, UK.
authors.forename: J G
authors.initials: JG
authors.lastname: Hussell
authors.forename: I D
authors.initials: ID
authors.lastname: Learmonth
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty; D001843:Bone Cements; D016025:Bone Transplantation; D005260:Female; D005269:Femur / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation
chemical_list: D001843:Bone Cements