Autograft acetabular reconstruction in cementless total hip arthroplasty

From January 1986 to June 1991, resected autogenous femoral head bone grafts were used here to augment major acetabular deficiencies during primary cementless total hip arthroplasty (THA) in 22 patients. Twenty patients (26 hips) with a minimal follow-up of 2 years (mean 62 months, range from 25 to 96 months) were reviewed. The average patient age was 52 (range, 21 to 63 years). The diagnosis was dysplastic hip with secondary osteoarthritis in 23 hips, 2 post-traumatic osteoarthritic hips, and one sequela of congenital dislocation of hip. The pre-operative hip ratings (modified d'Aubigne and Postel rating system) averaged 11.6 points (range, 9 to 13) and progressed to an average 17.1 points (range, 13 to 18) at the last follow-up. All grafts united roentgenographically with an average union period of 7.2 months (range, 6 to 12 months). One hip received revision of insert after marked polyethylene wear. One cup was definitely loose by radiographic criteria, but without revision because of this patient's refusal. Radiographic evidence of mild graft resorption was seen in six hips (23%). Dislocation occurred in one hip. Most patients were improved clinically by this procedure. This type of surgery can be chosen as an alternative method of treatment in patients with marked acetabular deficiency.