Results of Impaction Grafting in Revision Hip Arthroplasty at Two to Seven Years using Fresh and Irradiated Allograft Bone

The 2- to 7-year follow-up on 41 revision femoral arthroplasties performed using the impaction grafting technique and a collarless, polished, tapered stem is reported. Average age at surgery was 70 years (range 35 – 85) and femoral bone loss was Endoklinik grade 1 in 13.5%, grade 2 in 43.3%, grade 3 in 29.7% and grade 4 in 13.5%. Four patients died during the study period, three with well functioning implants and one with deep infection. Another implant had failed by 1 year with progressive subsidence and periprosthetic fracture and has been revised. Cumulative survival of femoral stems was 92% at 5 years. There were no dislocations. At latest follow-up (average 4 years) 86% of patients were satisfied and greatly improved with surgery (mean Harris hip score 75.1). Favourable radiological features of graft incorporation were observed in 77.5%. Although the follow-up period for the group receiving irradiated bone was slightly shorter, there was no significant difference in clinical or radiological outcomes between 20 patients who received fresh frozen allograft bone and 18 patients who received frozen irradiated allograft bone.