Influence of Freeze-Drying and Irradiation on Mechanical Properties of Human Cancellous Bone: Application to Impaction Bone Grafting

The use of a solid bone graft to restore bone stock and insure implant stability in hip revision surgery was introduced by Harris et al. (1). Better results have been obtained on the femoral site than on the acetabulum where high failure rate has been reported at ten years (2-7). Progressively, a new technique for restoring the acetabulum emerged with the concept of bone impaction which was introduced by Slooff et al. and later extended to the femur by Ling et al. (8-9). The technique consists in impacting bone chips with a phantom into the contained femoral or acetabular defect to produce a layer of tightly impacted bone where an implant shall be inserted with the cement being pressurized into the graft during cementation. Clinical results of impaction bone grafting techniques were largely improved with re-revision rates comparable to those observed after primary arthroplasty (10-12). Acetabular reconstructions were described as requiring between one and three femoral heads (12) and femoral impactions two or more, based on the preoperative bone loss (13-14).