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Cancellous Impaction Allografting for Femoral Component Revision in Total Hip Arthroplasty

Summary Several alternatives exist for revision of a failed femoral component after total hip arthroplasty when that failure occurs in association with severe bone stock deficiency. Cemented implants, cementless implants, proximal femoral replacement prostheses, and bulk allograft–prosthetic composites all have been described. Cancellous impaction allografting with cement is an additional alternative for femoral revision that can be used if bone stock is compromised. This technique involves creating a “neo-endosteum” by packing cancellous bone graft into the femoral canal and inserting a cemented prosthesis into the reconstructed femur. This review covers the history, indications, surgical technique, complications, and published clinical results of femoral impaction allografting.