Impaction Allografting for Massive Femoral Defects in Revision Hip Arthroplasty Using Collared Textured Stems

We present a prospective study of impaction grafting using collared textured stems in femurs with massive defects (defined as requiring >150 cm³ of cancellous allograft). Eighteen hips were followed for a minimum of 2 years. Average Harris hip scores increased from 50 preoperatively to 83 at most recent follow-up. Seventeen hips were functioning well at the time of most recent follow-up and exhibited no stem subsidence or aseptic loosening. One hip was associated with visible subsidence and required further revision. Single-photon emission computed tomography analyses performed at an average of 37 months indicated active graft reorganization in all cases studied. Impaction allografting with collared textured stems for massive defects demonstrates good intermediate-term clinical results and may be a useful alternative to allograft stem composites and megaprostheses.