Femoral Impaction grafting in revision Total Hip Arthroplasty: a 2 to 15 year follow-up of 540 cases
Femoral impaction bone grafting in conjunction with the Exeter cemented polished double-taper stem as a technique for revision of the femoral component was introduced in 1987 at our institution.
The results of femoral impaction grafting in the first 540 procedures of revision total hip arthroplasty with a 2-15 year follow-up were studied.
As at January 2000, 540 cases in 487 patients had been performed by multiple surgeons. All procedures have been studied prospectively with no patients lost to follow-up.
Survivorship at 15 years is 90.6 percent. Averaged clinical scores are as follows:
|
|
Charnley:
pain
|
Charnley:
function
|
Charnley:
RoM
|
Harris:
pain
|
Harris:
function
|
Oxford hip score
|
|
Post-operative
|
2.7
|
2.1
|
4.0
|
19
|
18
|
41
|
|
2yrs Post op
|
5.5
|
4.1
|
5.4
|
38
|
32
|
22
|
|
Latest follow up
|
5.3
|
3.6
|
5.3
|
36
|
28
|
25
|
There have been 45 failures (8.3 percent) at an average of 7.6 years post-operatively (range 2.6 – 15.3 years). Technical error contributed to 13 of the 24 non-infective complications, but with improved technique plus the introduction of the use of long stems with impaction grafting, there have been no technical errors since 1996.
In conclusion, our results show that revision of the femoral component with impaction bone grafting is a reliable and durable technique with an acceptably low complication rate with excellent survivorship at up to15 years.
|
