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The Journal of Bone and Joint Surgery 81:1337-45 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Current Status of Impaction Allografting for Revision of a Femoral Component*{dagger}{ddagger}

SETH S. LEOPOLD, MAJOR§, EL PASO, TEXAS and AARON G. ROSENBERG, M.D.#, CHICAGO, ILLINOIS

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons


   Introduction
 
There is a variety of reconstructive options for revision of a femoral component in the setting of loss of proximal bone stock. Techniques employing stems designed to be inserted with16,28,31,33 and without8,18,27 cement have demonstrated durable results on intermediate to long-term follow-up; the use of a bulk allograft1,4,34 and replacement of the proximal aspect of the femur have been advocated for patients who have a massive loss of bone stock24. This paper will focus on the clinical results of a newer technique in which allograft cancellous bone is impacted into the proximal aspect of the femoral canal to provide a so-called neo-endosteum for a component inserted with cement.

Impaction cancellous allografting for revision of a femoral component is a modification of a technique initially used for acetabular reconstruction in the setting of protrusio acetabuli32. To our knowledge, it was first used for femoral reconstruction without cement in 1985, . . . [Full Text of this Article]


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