Impaction Allografting for Femoral Revision Hip Arthroplasty. Mid-Term Results after Minimum Five Year Follow-Up in 46 Cases

Abstract

Previously, only short-term follow-up results after femoral revision using impacted allograft and cemented stems – the exchange technique – have been published. We present the results of 46 femoral exchange revision procedures performed on 42 patients with five to nine years follow-up. At follow-up, five patients had died and two patients did not complete follow-up. Two patients were re-revised. One patient underwent re-revision due to early collapse of the impaction construct. In another patient, stem loosening due to acetabular revision occurred and a full re-revision of the impaction area was performed. One patient suffered late post-operative femoral fracture and three patients experienced hip dislocations. Ninety percent expressed satisfaction with the result. Harris Hip Score (HHS) improved from 36 to 82 (p < 0.001). Radiographically, one patient demonstrated stem subsidence of greater than 5mm. Eighty-six percent demonstrated signs of graft incorporation and only one patient demonstrated signs of loosening. Our results after a minimum of five years’ follow-up of patients surgically treated with the exchange femoral revision technique demonstrated good clinical and radiological results. With a re-revision rate of 4.3%, one case with subsidence exceeding 5 mm and one case with diaphyseal fracture, we did not observe the problems of subsidence and femoral fractures described in previous studies.