Structural characteristics of impaction allografting for revision total hip arthroplasty

Background The impaction allografting procedure for treatment of failed hip reconstructions has shown promising but variable results. The objective of this study was to compare the structural characteristics of revision total hip arthroplasty constructs with impaction allografting (cement + morsellized bone) with all-cement and all-morsellized bone constructs. Methods Uniaxial cyclic compression was applied to a simplified uniaxial, parallel, aluminum tube model to simulate normal gait. Applied force and axial stem displacement were recorded to determine stem subsidence and construct stiffness. Findings Introduction of a small amount of cement into the bone graft, as suggested in an impaction allografting procedure previously reported, makes the construct behave structurally more similar to an all-cemented construct than to an all-bone graft construct. Interpretation The results suggest that the structural properties achieved in an impaction allografting construct are sensitive to the amount of cement in the graft and that care should be taken clinically to achieve consistent constructs.