Impaction Bone-Grafting before Insertion of a Femoral Stem with Cement in Revision Total Hip Arthroplasty. A Minimum Two-Year Follow-up Study* by JOHN

Impaction Bone-Grafting before Insertion of a Femoral Stem with Cement in Revision Total Hip Arthroplasty. A

Minimum Two-Year Follow-up Study*

by JOHN B. MEDING, MERRILL A. RITTER, E. MICHAEL KEATING, and PHILIP M. FARIS

J Bone Joint Surg AmVolume 79(12):1834-41

December 1, 1997

©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-A: Initial postoperative radiograph of a fifty-seven-year-old man who had impaction bone-grafting before insertion of the femoral stem with cement.

JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41


Fig. 1-B: Twenty-six months postoperatively, stress-oriented trabeculae (arrow) have formed, especially medially and about the middle of the stem.



Fig. 2-A Radiograph of a sixty-nine-year-old woman, showing loosening of the cup and proximal femoral osteolysis twenty years after a left total hip replacement in which the femoral stem was

inserted with cement.



Fig. 2-B Two months after revision with impaction bone-grafting, there is abundant allograft and minimum thickness of the cement about the stem.



Fig. 2-C Three years postoperatively, there is a relative loss of radiodensity of the periprosthetic allograft, consistent with vascular ingrowth.



Fig. 3-A Radiograph of a seventy-six-year-old woman, made twenty-one years after a left total hip replacement in which the stem was inserted with cement.



Fig. 3-B: Initial radiograph made after revision with impaction bone-grafting, showing the thin medial cortical shell (arrow).



Fig. 3-C: Three years postoperatively, there has been remodeling and reconstitution of the medial cortical bone (arrow).



Documents

Impaction Bone-Grafting before Insertion of a Femoral Stem with Cement in Revision Total Hip Arthroplasty. A Minimum Two-Year Follow-up Study* by JOHN