[Impaction morselized allografting combined with cementless long stem for femoral defects in femoral component revision].
OBJECTIVE
To retrospectively analyze the clinical and radiological results of the impaction morselized allografting combined with cementless long stem for femoral component revision in patients with significant bone loss.


METHODS
From July 2003 to June 2009, 27 patients (27 hips) underwent revision hip arthroplasty in femurs with bone defect using impaction allografting and cementless components. There were 15 male and 12 female with mean age of 67 years. According to the Paprosky classification system, the bone defects in femur were classified into type II in 3 cases, type III in 21 cases and type IV 3 cases. The patients were followed up postoperatively to observe the clinical and radiological results, and if there had the stem subsidence, periprosthetic fracture, infection and other complications.


RESULTS
Twenty-three patients were followed up. The mean follow-up time was 26 months. Harris score improved from 43 points pre-revision to 83 points at the final follow-up. No femoral stem loosening and failure occurred. There were 4 stem with a mean 3.3 mm subsidence. One case had an acute infection after revision and treated successfully by debridement and drainage, antibiotics. No stem need further revision. Radiographic analysis showed all the revised stem was stable, and graft incorporation was seen in at least 1 zone in 100% of the femurs.


CONCLUSIONS
The results of this study demonstrates that femoral support and vigorous impaction grafting combined with cementless long stem results in an good intermediated-term clinical effects.
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, China.
Jing
J
Yang
Peng-de
PD
Kang
Bin
B
Shen
Zong-Ke
ZK
Zhou
Fu-Xing
FX
Pei
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome