http://www.bjj.boneandjoint.org.uk/content/95-B/11_Supple_A/92.abstract

Femoral stem impaction grafting: extending the role of cement

1. T. Gehrke, MD, Medical Director1;
2. M. Gebauer, MD, Attending1; and
3. D. Kendoff, MD, PhD, Attending2

+ Author Affiliations

1. 1Helios Endo Klinik Hamburg, Holstenstr.2, 22767 Hamburg, Germany.
2. 2Helios Endo Klinik Hamburg, Holstenstr.2, 22767 Hamburg, Germany.

1. Correspondence should be sent to Dr D. Kendoff; e-mail:daniel.kendoff@endo.de

Abstract

Femoral revision after cemented total hip replacement (THR) might include technical difficulties, following essential cement removal, which might lead to further loss of bone and consequently inadequate fixation of the subsequent revision stem.

Femoral impaction allografting has been widely used in revision surgery for the acetabulum, and subsequently for the femur. In combination with a primary cemented stem, impaction grafting allows for femoral bone restoration through incorporation and remodelling of the impacted morsellized bone graft by the host skeleton. Cavitary bone defects affecting meta-physis and diaphysis leading to a wide femoral shaft, are ideal indications for this technique. Cancellous allograft bone chips of 1 mm to 2 mm size are used, and tapered into the canal with rods of increasing diameters. To impact the bone chips into the femoral canal a prosthesis dummy of the same dimensions of the definitive cemented stem is driven into the femur to ensure that the chips are very firmly impacted. Finally, a standard stem is cemented into the neo-medullary canal using bone cement.

To date several studies have shown favourable results with this technique, with some excellent long-term results reported in independent clinical centres worldwide.

Cite this article: Bone Joint J 2013;95-B, Supple A:92–4.

Footnotes

• No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
  This paper is based on a study which was presented at the 29th Annual Winter 2012 Current Concepts in Joint Replacement® meeting held in Orlando, Florida, 12th – 15th December.

• Received August 13, 2013.
• Accepted August 13, 2013.

• ©2013 The British Editorial Society of Bone & Joint Surgery