ABSTRACT
Even with the so-called second-or third-generation cementing technique, cemented femoral revision is a problem [1,2]. The greater the number of revisions, the lower is the survival rate [3-5]. This is because bone stock does not recover spontaneously without grafting as cement occupies the areas of bone loss [6] and the cement/bone interface is weak as there is little cancellous bone into which cement can penetrate [7]. In cemented femoral revision without bone grafting, radiolucent lines at the cement/bone intetiace are often seen on the immediate postoperative x-ray, indicating that the new implant is loose and has limited prospects of long-term survival (Fig. I) [8]. To avoid these problems of cemented femoral revision, we introduced the new technique of bone grafting in the mid-1980s. The aim was to improve bone stock, particularly in young patients, to make any subsequent revision easier and to improve cement/bone fixation to decrease the rate of loosening.
