Operative Technique: Autologous Impaction Bone Grafting With Uncemented Corail Stem in Primary Total Hip Arthroplasty

Abstract

The value of uncemented fixation using hydroxyapatite-coated femoral implants is now widely recognized, and the Corail has become a gold standard among stems in primary total hip arthroplasty. There have been some concerns over subsidence, loosening, and fracture in osteoporotic bone precluding the use of uncemented stems in patients with poor quality bone. The main issue appears to be lack of cancellous bone cushioning resulting in point loading of prosthesis against cortical bone. We describe a novel surgical technique utilizing the patient’s own femoral head as an autogenic source of cancellous bone graft, impacted into the proximal femoral metaphysis before implanting the stem, in order to improve the quality of bone envelope. This surgical technique is safe and simple to perform and may increase patient’s bone stock.