Use of an anatomic long-stemmed component in femoral impaction grafting

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We describe a challenging femoral revision for aseptic loosening in a relatively young and active man. The femur had gross osteolysis, an absent calcar and a cortical diaphyseal defect at the level of the isthmus (Paprosky 3b defect).

The cortical defects were repaired and the whole femur then restored with Femoral Impaction Grafting (FIG) using custom-made impaction instruments and an anatomic shaped collarless, polished, tapered femoral component.

In the active adult, bone restoring revision techniques such as impaction grafting should be considered to give a realistic prospect of host bone augmentation rather than simply aiming for a distally fixed stem in a patulous femoral canal.

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