Impaction allografting for femoral component revision in total hip arthroplasty: Surgical indications, techniques, and review of results

Abstract

Several options have been described for revision of a failed femoral component in total hip arthroplasty. When severe bone-stock deficiency is present, techniques using cemented implants, cementless implants, allograft-prosthetic composites, and proximal femoral replacement prostheses have all been used. The present report focuses on a new technique: cancellous impaction allografting with cement. This reconstructive option involves inserting and shaping tightly packed cancellous bone into the femoral canal to create a so-called “neo-endosteum,” into which a prosthesis is inserted with cement. This article includes a brief history of the technique, an algorithm of surgical indications for the various femoral revision techniques, a summary of the surgical method as well as technical tips, the known complications of impaction allografting, and a review of published clinical results regarding this relatively new technique.