title: Impaction allografting with cement for extensive femoral bone loss in revision hip surgery: a 4- to 8-year follow-up study.
abstract: The current study evaluates the 4- to 8-year results of 26 cemented femoral revisions with impaction allografting using a collared femoral component in cases of extensive femoral bone loss. Patients were followed prospectively and were evaluated at an average of 6.0 years after the allograft revision procedure. The average age at the time of surgery was 69.3 years. At final follow-up, 20 patients (20 hips) were living, and 6 patients (6 hips) were deceased. No femoral component rerevisions were performed for any reason in any patient, and none were radiographically loose at final follow-up. There was 1 subsided femoral component of <5 mm, 3 postoperative periprosthetic femoral fractures, and a greater trochanter nonunion rate of 32%. At the current follow-up interval, these cemented femoral revisions with impaction allografting have performed well with excellent clinical and radiographic durability in this difficult patient population. The prevalence of periprosthetic fracture is a significant concern. This study shows durable results using the impaction allografting technique in cases of severe bone loss.
authors.affiliation: Department of Orthopaedic Surgery, University of Iowa Health Care, Iowa City, Iowa 52242, USA.
authors.forename: G B
authors.initials: GB
authors.lastname: Fetzer
authors.forename: J J
authors.initials: JJ
authors.lastname: Callaghan
authors.forename: J E
authors.initials: JE
authors.lastname: Templeton
authors.forename: D D
authors.initials: DD
authors.lastname: Goetz
authors.forename: P M
authors.initials: PM
authors.lastname: Sullivan
authors.forename: R C
authors.initials: RC
authors.lastname: Johnston
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D016025:Bone Transplantation / Q000379:methods*; D002484:Cementation; D005260:Female; D005269:Femur / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D014184:Transplantation, Homologous; D016896:Treatment Outcome