Abstract
Aims: To evaluate the radiological evidence of graft incorporation in the femur following impaction bone grafting. Methods: Consecutive patients that underwent femoral impaction bone grafting using two stem designs were identified. Radiographs were taken post-op and at 3, 6 and 12 months then yearly. They were evaluated for radiological signs of graft incorporation and the results plotted against time and according to Gruen zones. Results: 28 patients over a 4-year period underwent femoral impaction grafting. 16 had a double tapered polished stem (Exeter), 12 had a non-polished stem (Charnley Elite). There were 17 male and 11 female patients with an average age of 62.6 years.
There is little radiological evidence of incorporation before 6 months, but by one year 75% of patients show some graft incorporation in some or all Gruen zones. Graft incorporation in the Exeter stems is seen first in zones 4 and 5. In the Charnley stems it is first seen in zones3, 5 and 6. The majority of subsidence occurs within the first year following surgery. Conclusions: Graft incorporation is seen first in those zones that may be expected to experience greater load. Differences in the pattern of graft incorporation may reflect differences in stress distribution between the two stem designs. Some load appears to promote graft incorporation. The construct must have sufficient stability to withstand subsidence whilst graft incorporation occurs.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
