Exchange impaction allografting for femoral revision hip arthroplasty: results in 87 cases after 3.6 years' follow-up

Abstract

A total of 87 femoral exchange revision procedures were performed in 80 patients. Mean follow-up time was 3.6 years. Patients were followed prospectively. At follow-up, 5 patients had died, and 74 (93 %) completed follow-up. Results were evaluated on the basis of incidence of re-revisions and other complications, patient satisfaction, and preoperative and postoperative Harris hip score. Radiographic evaluation included preoperative femoral bone status evaluated according to Endo-Klinik and Mallory, incidence of subsidence, bone-graft incorporation, and signs of loosening. Three patients were re-revised, 2 patients suffered postoperative femoral fractures, 5 patients had hip dislocations, and 1 patient suffered deep infection. Of patients, 90% expressed satisfaction with the result. Harris hip score improved from 39 to 82 (P <.001). Radiographically, only 2 patients showed subsidence of >5 mm. Of patients, 88% showed signs of graft incorporation, and only 1 patient showed signs of loosening. Intermediate follow-up evaluation of the exchange femoral revision technique showed good clinical and radiographic results. With a re-revision rate of 3.5% and incidence of >5 mm subsidence of 2.5%, we did not observe the problems of subsidence and femoral fractures that previous studies have described.