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 Adult Hip Reconstruction Test 8: Total Hip Arthroplasty Results
CME 3: July, August, September 2004
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The Journal of Bone and Joint Surgery (American) 86:2050-2060 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Impaction Bone-Grafting in Revision Joint Replacement Surgery

Andrew D. Toms, MBChB, FRCS(Ed), MSc, FRCS(Tr+Orth)1, Ross L. Barker, FRCS2, Richard Spencer Jones, MB, BS, FRCS, FRCS(Tr+Orth)2 and Jan Herman Kuiper, PhD2

1 35 Simpsons Walk, Horsehay, Telford, Shropshire TF4 2PA, England. E-mail address: toms{at}at-rj.freeserve.co.uk
2 Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire SY10 7AG, England

Investigation performed at the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, England

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The standard graft material for impaction bone-grafting is fresh-frozen femoral head allograft morselized to a particle size as large as is practical to ensure stability and allow new bone formation.

The graft must be sufficiently compacted to provide immediate mechanical stability; this requires containment of the graft and substantial impaction energy.

Diaphyseal bone fracture and excessive implant migration are the most common complications of the operation.

Impaction bone-grafting in revision total hip replacement has produced good medium-term results on both the acetabular and the femoral side.

The use of compacted morselized bone graft is a relatively new technique in revision knee surgery and requires longer-term follow-up with larger numbers of patients to assess its value.


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