Revision total hip arthroplasty using impaction bone grafting with cemented nonpolished stems and Charnley cups

This article reports the results of 181 cemented revision total hip arthroplasties in which impacted morcellized allograft and cement was used for reconstitution of acetabular and femoral bone deficiencies. There were 173 acetabular and 79 femoral reconstructions. The mean follow-up was 4.0 years. The overall survival rate was 97.2%. Evidence of revascularization of the impacted allograft was shown in 29 of 30 (97%) randomly selected bone scintigraphies. Radiographic evidence of allograft incorporation was observed in 128 of 173 (74%) acetabula and 48 of 73 (61%) femora. Stem subsidence occurred in all types of femoral bone deficiencies and was not time dependent (P =.17). The acetabular components showed significant migration with increased bone deficiency (P =.0003). Impaction bone grafting has shown promising results in revision total hip arthroplasty but is not recommended in type 3 acetabular defects.