Impaction Bone-Grafting in Revision Joint Replacement Surgery

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.