The Evolution of the Technique of Impaction Bone Grafting in Femoral Revision Surgery has Improved Clinical Outcome. A Prospective Mid-Term Study

Ninety-three patients (97 hips) underwent impaction bone grafting (IBG) using a cemented tapered femoral stem at our institution. Forty-one hips were operated between 1993 and 1998 (group 1) and 56 hips between 1999 and 2007 (group 2). The use of an extended trochanteric osteotomy and a long stem was more frequent in group 2. Group 2 hips showed a better clinical result. One hip was revised for aseptic loosening and most failures were early periprosthetic fractures. The survival rate for reoperation for any cause was 82.9% for group 1 and 84.3% for group 2. Patients in group 1 had a higher risk for periprosthetic fractures and radiological subsidence >5 mm. Experience and the evolution of the IBG technique have improved the good long-term outcome.