This Exeter centre series reports 10–11 year outcomes of femoral impaction grafting with cement across 226 revision hips performed by 32 surgeons, documenting how the technique and its indications evolved as clinical experience and dedicated instrumentation accumulated.
When performing femoral impaction grafting in revision THA, periprosthetic fracture — not aseptic loosening.
Is the primary threat to the construct: scrutinise intraoperative films for unrecognised fractures and use a long stem whenever host bone at the tip of a conventional stem is compromised or Endo-Klinik grade 3–4 bone loss is present.
Expect the polished Exeter stem to subside within the cement mantle. Subsidence alone, even >10 mm, does not indicate failure if the patient is pain-free and radiographs show stabilisation.
This Exeter centre series reports 10–11 year outcomes of femoral impaction grafting with cement across 226 revision hips performed by 32 surgeons, documenting how the technique and its indications evolved as clinical experience and dedicated instrumentation accumulated.
When performing femoral impaction grafting in revision THA, periprosthetic fracture — not aseptic loosening.
Is the primary threat to the construct: scrutinise intraoperative films for unrecognised fractures and use a long stem whenever host bone at the tip of a conventional stem is compromised or Endo-Klinik grade 3–4 bone loss is present.
Expect the polished Exeter stem to subside within the cement mantle. Subsidence alone, even >10 mm, does not indicate failure if the patient is pain-free and radiographs show stabilisation.