Impaction Bone-Grafting before Insertion of a Femoral Stem with Cement in Revision Total Hip...
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![Page 1: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/1.jpg)
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.
![Page 2: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/2.jpg)
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
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/3.jpg)
Fig. 1-B: Twenty-six months postoperatively, stress-oriented trabeculae (arrow) have formed, especially medially and about the middle of the stem.
JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/4.jpg)
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.
JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/5.jpg)
Fig. 2-B Two months after revision with impaction bone-grafting, there is abundant allograft and minimum thickness of the cement about the stem.
JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/6.jpg)
Fig. 2-C Three years postoperatively, there is a relative loss of radiodensity of the periprosthetic allograft, consistent with vascular ingrowth.
JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/7.jpg)
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.
JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/8.jpg)
Fig. 3-B: Initial radiograph made after revision with impaction bone-grafting, showing the thin medial cortical shell (arrow).
JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: 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.](https://reader036.fdocuments.us/reader036/viewer/2022082518/5697c0211a28abf838cd2c88/html5/thumbnails/9.jpg)
Fig. 3-C: Three years postoperatively, there has been remodeling and reconstitution of the medial cortical bone (arrow).
JOHN B. MEDING et al. J Bone Joint Surg Am 1997;79:1834-41
©1997 by The Journal of Bone and Joint Surgery, Inc.