title: Revision total hip arthroplasty using impaction bone grafting with cemented nonpolished stems and charnley cups.
abstract: This article reports the results of 181 cemented revision total hip arthroplasties in which impacted morcellized allograft and cement was used for reconstitution of acetabular and femoral bone deficiencies. There were 173 acetabular and 79 femoral reconstructions. The mean follow-up was 4.0 years. The overall survival rate was 97.2%. Evidence of revascularization of the impacted allograft was shown in 29 of 30 (97%) randomly selected bone scintigraphies. Radiographic evidence of allograft incorporation was observed in 128 of 173 (74%) acetabula and 48 of 73 (61%) femora. Stem subsidence occurred in all types of femoral bone deficiencies and was not time dependent (P =.17). The acetabular components showed significant migration with increased bone deficiency (P =.0003). Impaction bone grafting has shown promising results in revision total hip arthroplasty but is not recommended in type 3 acetabular defects.
authors.affiliation: Joint Replacement Unit, East Surrey Hospital, Surrey, United Kingdom. jgboldt@hotmail.com
authors.forename: J G
authors.initials: JG
authors.lastname: Boldt
authors.forename: P
authors.initials: P
authors.lastname: Dilawari
authors.forename: S
authors.initials: S
authors.lastname: Agarwal
authors.forename: K J
authors.initials: KJ
authors.lastname: Drabu
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D002484:Cementation; D005260:Female; D005269:Femur / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D011877:Radionuclide Imaging; D012086:Reoperation; D014184:Transplantation, Homologous; D016896:Treatment Outcome