Clinical and radiographic outcomes of acetabular impaction grafting without cage reinforcement for revision hip replacement

a minimum ten-year follow-up study

J. Gilbody, C. Taylor, G. E. Bartlett, S. L. Whitehouse, M. J. W. Hubble, A. J. Timperley, J. R. Howell, M. J. Wilson


Impaction bone grafting for the reconstitution of bone stock in revision hip surgery has been used for nearly 30 years. Between 1995 and 2001 we used this technique in acetabular reconstruction, in combination with a cemented component, in 304 hips in 292 patients revised for aseptic loosening. The only additional supports used were stainless steel meshes placed against the medial wall or laterally around the acetabular rim to contain the graft. All Paprosky grades of defect were included. Clinical and radiographic outcomes were collected in surviving patients at a minimum of ten years after the index operation. Mean follow-up was 12.4 years (sd 1.5) (10.0 to 16.0). Kaplan–Meier survival with revision for aseptic loosening as the endpoint was 85.9% (95% CI 81.0 to 90.8) at 13.5 years. Clinical scores for pain relief remained satisfactory, and there was no difference in clinical scores between cups that appeared stable and those that appeared radiologically loose.

Cite this article: Bone Joint J 2014;96-B:188–94.


  • The authors are grateful to Ros Schulpher, Sandy Wraight and Leo Collett of the Exeter Hip Research Team for their assiduous work in data collection and validation. We would also like to thank Mr Graham Gie for his invaluable contribution to this work.

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

    This article was primary edited by G. Scott and first proof edited by D. Rowley.

  • Received April 2, 2013.
  • Accepted October 29, 2013.
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