Abstract
To establish the efficacy of femoral impaction grafting in femoral reconstruction following sepsis, we identified and reviewed all cases of two stage hip revision for sepsis in which femoral impaction grafting was used in the second stage, performed in Exeter from 1989 until the end of 1998. All patients underwent a Girdlestone excisional arthroplasty, were prescribed local and systemic antibiotic treatment, and then subsequently underwent surgical reconstruction, using femoral impaction grafting.
These 53 cases represent a subgroup of our patients who had received a two-stage revision for infection during that period. The other patients did not require femoral grafting. 4 patients died within 24 months of surgery.
4 patients became reinfected (7.5%), and 1 patient underwent stem revision for a fracture below the tip of the stem at 10 months, leaving 44 patients with an average of 53 months follow up (range 24 to 122 months). These 44 patients all demonstrated improved clinical scores and satisfactory radiological outcomes.
Our clinical results reveal post-operative scores approaching those for primary arthroplasty. Our intermediate term results justify the use of fresh frozen allograft bone in the second stage of revisional hip surgery for its low incidence of reinfection and loosening, and potential to improve bone stock.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
