Results of hip revision using the exeter stem, impacted allograft bone, and cement

The Exeter stem and impacted, morselized allograft bone and cement were use d in the revisions of 18 consecutive femoral components (17 patients). The primary arthroplasty had been done because of osteoarthritis. All of the fe moral components were revised for the first time because of aseptic looseni ng. The migration pattern of the Exeter stem after revision was studied usi ng roentgen stereophotogrammetric analysis. At 2 years after surgery, all 1 8 femoral stems had migrated in the distal direction (average, 2.5 mm). In addition, seven of the stems had migrated in the medial direction (average, 1.3 mm), and two stems had migrated in the lateral direction (0.5 nun and 1 mn, respectively). Sixteen of the femoral stems also had migrated in the posterior direction (average, 2.9 mm), but none migrated in the anterior di rection. The migration rate decreased gradually with time during the follow up. Six femoral stems continued to migrate between 1.5 and 2 years after su rgery. In patients with major femoral bone deficiency at the time of hip re vision, the use of impacted morselized allograft bone and cement yielded an initial fixation similar to that obtained in conventionally cemented revis ions. Pain had improved in all patients at the 2-year followup.