title: Survivorship Analysis of Eighty Revised Hip Arthroplasties With the Impaction Grafting Technique Using Whole Femoral Head Allografts With the Articular Cartilage.
abstract: Acetabular impaction bone grafting aims to restore anatomy in hip revision surgery. This is an effective but expensive and time-consuming technique. Usually, the articular cartilage is removed from the femoral head allograft. We aimed to reproduce the same results retaining the cartilage of the allograft.
  
  
  
  Eighty acetabular revisions using impacted morselized bone graft retaining the articular cartilage and a cemented cup were studied retrospectively. Six were lost during follow-up. The mean follow-up was 6.5 years (range 1-13). Clinical and radiological assessment was made using the Oxford Hip Score, Hodgkinson's criteria for socket loosening, and the Gie classification for evaluation of allograft incorporation.
  
  
  
  Sixty-three sockets (85.1%) were considered radiologically stable (type 0, 1, and 2 demarcations), 8 (10.8%) were radiologically loose (type 3), and 3 (4.1%) presented with migration. Fifty-one (68.9%) cases showed good trabecular remodeling (grade 3), 20 (27%) showed trabecular incorporation (grade 2), and 3 (4.1%) showed poor allograft incorporation. Mean preoperative hip score was 43 and postoperative score was 28. Six (8.1%) cases presented heterotopic ossification around the revised implants, 2 patients (2.7%) had periprosthetic fractures, and 4 (5.4%) had dislocations. The Kaplan-Meier survivorship at a mean of 6.5 years with revision of the cup for any reason was 95.9% (95% confidence interval 5.6-7.5).
  
  
  
  The mid-term results of our technique are promising. Particularly when the supply of fresh-frozen allografts and surgical time is limited, using whole femoral head with articular cartilage is both safe and effective.
authors.affiliation: Center for Hip Surgery, Department Of Orthopaedics, Wrightington Hospital, Wigan, Lancashire, UK.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fadulelmola
authors.affiliation: Center for Hip Surgery, Department Of Orthopaedics, Wrightington Hospital, Wigan, Lancashire, UK.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Drampalos
authors.affiliation: Center for Hip Surgery, Department Of Orthopaedics, Wrightington Hospital, Wigan, Lancashire, UK.
authors.forename: John
authors.initials: J
authors.lastname: Hodgkinson
authors.affiliation: Center for Hip Surgery, Department Of Orthopaedics, Wrightington Hospital, Wigan, Lancashire, UK.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Hemmady
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D005269:Femur / Q000601:surgery; D005270:Femur Head / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D000073859:Survivorship; D014184:Transplantation, Homologous; D016896:Treatment Outcome
keywords: articular cartilage; femoral head allograft; impaction bone grafting; revision hip arthroplasty; survivorship