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What is the Long-term Survival of Impaction Allografting of the Femur?

  • Symposium: 2012 International Hip Society Proceedings
  • Published:
Clinical Orthopaedics and Related Research®

An Erratum to this article was published on 25 April 2013

Abstract

Background

Revision hip surgery of the femur for patients with substantial bone loss is challenging. We previously reported 41 patients (44 hips) treated with femoral impaction grafting followed for a minimum of 2 years. The survivorship, using femoral reoperation for symptomatic aseptic loosening as the end point, was 97% at 8 years. However, data on longer term survival are crucial to adequately compare this surgical technique with other types of revision hip arthroplasty procedures.

Questions/purposes

We therefore asked what the survivorship of impaction bone grafting was at longer followup, if the severity of bone loss was associated with failure, and finally, if longer length stems had improved survival compared with shorter stems.

Methods

Between 1993 and 2002, 78 femoral revisions were performed in 71 patients using impaction grafting. The average age of the patients was 67 years (range, 33–84 years). Sixty-nine of the 71 patients were available for followup evaluation. We obtained Harris hip scores preoperatively and postoperatively. Radiographs were measured for radiolucent lines. Patients were followed a minimum of 2 years (average, 10.6 years; range, 2–19 years).

Results

Survival of the femoral component without revision for any cause was 93% (confidence interval [CI], 83%–97%) and for aseptic loosening was 98% (CI, 87%–100%) at 19 years. Neither severity of bone loss nor the length of the stem predicted failure.

Conclusions

Impaction bone grafting has a high survival of 93% at the 19-year followup for patients with severe bone loss of their femur.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dana M. Schwarz RN, for her assistance with the manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, 981080, Omaha, NE, 68198-1080, USA

    Kevin L. Garvin MD, Beau S. Konigsberg MD, Natalie D. Ommen MPT & Elizabeth R. Lyden MS

  2. College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Natalie D. Ommen MPT

  3. College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    Elizabeth R. Lyden MS

Authors
  1. Kevin L. Garvin MD
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  2. Beau S. Konigsberg MD
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  3. Natalie D. Ommen MPT
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  4. Elizabeth R. Lyden MS
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Corresponding author

Correspondence to Kevin L. Garvin MD.

Additional information

None of the authors nor has their institution received funding related to the content of this study. One or more of the authors (KLG) has received funding that is not related to the content of this manuscript. The funding source includes Biomet (Warsaw, IN, USA) (KLG) in the amount of USD 100,000 to USD 1,000,000. The institution of the authors has received funding from TRAK Surgical Inc (Omaha, NE, USA), Smith & Nephew (Memphis, TN, USA), Biomet, Vanguard (Valley Forge, PA, USA), Exponent (Menlo Park, CA, USA), Gruppo Bioimplanti (St Paul, MN, USA), and Renovis (Redlands, CA, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that the institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained.

This work was performed at the University of Nebraska Medical Center, Omaha, NE, USA.

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Garvin, K.L., Konigsberg, B.S., Ommen, N.D. et al. What is the Long-term Survival of Impaction Allografting of the Femur?. Clin Orthop Relat Res 471, 3901–3911 (2013). https://doi.org/10.1007/s11999-013-2954-2

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  • DOI: https://doi.org/10.1007/s11999-013-2954-2

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