title: Exchange impaction allografting for femoral revision hip arthroplasty: results in 87 cases after 3.6 years' follow-up.
abstract: A total of 87 femoral exchange revision procedures were performed in 80 patients. Mean follow-up time was 3.6 years. Patients were followed prospectively. At follow-up, 5 patients had died, and 74 (93 %) completed follow-up. Results were evaluated on the basis of incidence of re-revisions and other complications, patient satisfaction, and preoperative and postoperative Harris hip score. Radiographic evaluation included preoperative femoral bone status evaluated according to Endo-Klinik and Mallory, incidence of subsidence, bone-graft incorporation, and signs of loosening. Three patients were re-revised, 2 patients suffered postoperative femoral fractures, 5 patients had hip dislocations, and 1 patient suffered deep infection. Of patients, 90% expressed satisfaction with the result. Harris hip score improved from 39 to 82 (P <.001). Radiographically, only 2 patients showed subsidence of >5 mm. Of patients, 88% showed signs of graft incorporation, and only 1 patient showed signs of loosening. Intermediate follow-up evaluation of the exchange femoral revision technique showed good clinical and radiographic results. With a re-revision rate of 3.5% and incidence of >5 mm subsidence of 2.5%, we did not observe the problems of subsidence and femoral fractures that previous studies have described.
authors.affiliation: Department of Orthopaedics, Silkeborg Sygehus, Silkeborg, Denmark. martinlind@dadlnet.dk
authors.forename: Martin
authors.initials: M
authors.lastname: Lind
authors.forename: Niels
authors.initials: N
authors.lastname: Krarup
authors.forename: Søren
authors.initials: S
authors.lastname: Mikkelsen
authors.forename: Erik
authors.initials: E
authors.lastname: Hørlyck
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D016025:Bone Transplantation; D005269:Femur / Q000473:pathology*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D011182:Postoperative Care; D011446:Prospective Studies; D011859:Radiography; D012086:Reoperation; D013997:Time Factors; D014184:Transplantation, Homologous