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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 1, 37-43.
doi: 10.1302/0301-620X.91B1.20376  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Subsidence of the stem after impaction bone grafting for revision hip replacement using irradiated bone

M. Hassaballa, MCH Ortho, MD Ortho, Senior Fellow1; S. Mehendale, FRCS, FRCS Ortho, Specialist Registrar1; S. Poniatowski, BSc(Hons), National Tissue Bank Manager1; G. Kalantzis, MBBCH, Senior House Officer1; E. Smith, FRCS, Consultant Orthopaedic Surgeon1; and I. D. Learmonth, FRCS, Professor of Orthopaedic Surgery1

1 Avon Orthopaedic Centre, Southmead Hospital, Westbury on Trym, Bristol BS10 9NB, United Kingdom

Correspondence should be sent to Mr M. Hassaballa; e-mail: mahassaballa{at}aol.com

Loss of bone stock is a major problem in revision surgery of the hip. Impaction bone grafting of the femur is frequently used when dealing with deficient bone stock. In this retrospective study a consecutive series of 68 patients (69 hips) who had revision of a hip replacement with femoral impaction grafting were reviewed. Irradiated bone allograft was used in all hips. Radiological measurement of subsidence of the stem, incorporation of the graft and remodelling was carried out and showed incorporation of the graft in 26 of 69 hips (38%). However, there was no evidence of trabecular remodelling. Moderate subsidence of 5 mm to 10 mm occurred in ten hips (14.5%), and massive subsidence of > 10 mm in five (7.2%).

The results of this study are less favourable than those of others describing studies of revision of the femoral stem using impaction bone grafting. The absence of the characteristic changes of graft remodelling noted in other series raises the question as to whether irradiated bone graft may be a significant factor influencing the post-operative outcome.




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 J Bone Joint Surg BrHome page
L. Kerboull, M. Hamadouche, and M. Kerboull
Impaction grafting in association with the Charnley-Kerboull cemented femoral component: OPERATIVE TECHNIQUE AND TWO- TO 16-YEAR FOLLOW-UP RESULTS
J Bone Joint Surg Br, March 1, 2009; 91-B(3): 304 - 309.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General