Impaction Grafting in Primary Total Hip Arthroplasty: A Pilot Study

The quality of bone encountered in the proximal femur at primary total hip arthroplasty varies considerably. It would be advantageous to improve the bone stock quality of patients who are likely to require subsequent revision. Impaction grafting with morsellised autograft was performed at primary total hip arthroplasty on seven patients who had poor proximal femoral bone stock. Minimum follow-up was 33 months. One patient died 5 weeks post-operatively. Radiographic assessment showed improved bone stock in five hips with little or no improvement in one hip. There was no evidence of prosthetic subsidence. Impaction grafting at primary total hip arthroplasty is a viable method of improving bone stock in patients with poor proximal femoral bone quality. The technique would be of particular benefit in the younger patient presenting for total hip arthroplasty with poor bone stock in the proximal femur.