Preliminary report of impaction grafting for exchange femoral arthroplasty

J. J. Elting*, W. E M Mikhail, B. A. Zicat, J. C. Hubbell, L. E. Lane, B. House

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

168 Citations (Scopus)


Gie and Ling have described a method for femoral component revision using compressed morselized cancellous allograft and a cemented collarless polished taper stem. The authors report their early experience with this technique. Of the first 67 patients who had femoral exchange by impaction grafting, 60 were alive 2 to 5 years after hip revision; 2 hips failed because of late sepsis, and 5 patients were deceased. In 56 individuals available for review, the Harris Hip Score average was 90 points, with >80% reporting no pain. On radiograph, 48% of the stems showed an average of 2.8 mm of subsidence in the polymethyl-methacrylate mantle, but only 7% of the cement graft composites had subsided in the cortical tube. Lucent lines were rare, and in 93% of revised femurs the radiographs showed evidence of graft incorporation and bone remodeling. There were 6 reoperations in the group: 3 for late fracture of the femoral shaft and 3 for cup exchange (2 chronically dislocating, 1 loose). No evidence for femoral component loosening was found in this group. Further study is necessary, but these preliminary findings give rise to cautious optimism that this is a reliable method for femoral revision, reconstruction, and reconstitution.

Original languageEnglish
Pages (from-to)159-167
Number of pages9
JournalClinical Orthopaedics and Related Research
Issue number319
Publication statusPublished - 1995
Externally publishedYes


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