title: Use of an anatomic long-stemmed component in femoral impaction grafting.
abstract: We describe a challenging femoral revision for aseptic loosening in a relatively young and active man. The femur had gross osteolysis, an absent calcar and a cortical diaphyseal defect at the level of the isthmus (Paprosky 3b defect). The cortical defects were repaired and the whole femur then restored with Femoral Impaction Grafting (FIG) using custom-made impaction instruments and an anatomic shaped collarless, polished, tapered femoral component.In the active adult, bone restoring revision techniques such as impaction grafting should be considered to give a realistic prospect of host bone augmentation rather than simply aiming for a distally fixed stem in a patulous femoral canal.
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter - UK.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Westerman
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter - UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Timperley
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D016025:Bone Transplantation; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation