What is the Long-term Survival of Impaction Allografting of the Femur?
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Clin Orthop Relat Res DOI 10.1007/s11999-013-2954-2
A Publication of The Association of Bone and Joint Surgeons®
SYMPOSIUM: 2012 INTERNATIONAL HIP SOCIETY PROCEEDINGS
What is the Long-term Survival of Impaction Allografting of the Femur? Kevin L. Garvin MD, Beau S. Konigsberg MD, Natalie D. Ommen MPT, Elizabeth R. Lyden MS
Ó The Association of Bone and Joint Surgeons1 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.
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 FDAapproval 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.
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%)
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