Cementless total hip arthroplasty using an autograft of the femoral head for marked acetabular dysplasia: case series.
OBJECTIVE
To assess the short-term outcome of cementless total hip arthroplasty involving an autograft of the femoral head in Japanese patients.


METHODS
Cementless total hip arthroplasty with autogenous bone block grafting was performed on 18 hips in 15 patients with marked acetabular dysplasia. The resected femoral head was used as a graft for the superior-lateral region of the true acetabulum. Clinical outcome was correlated with the placement of the acetabular component, as revealed in radiographs.


RESULTS
The 13 women and 2 men had a mean age of 60.2 years (range, 37.0-73.0 years) at primary surgery and a mean follow-up duration of 3.3 years (range, 2.0-5.3 years). According to the classification of Crowe, 4 hips were in group I, 3 were in group II, one in group III, and 10 in group IV. The mean Harris Hip Score preoperatively was 45.7 (range, 19-69) and that at follow-up was 82.5 (range, 44-100). All 15 cases showed a good clinical outcome. There were no major intra-operative complications in this series. The grafted bones united in all patients. Two patients need surgical revision because the lateral insertion of the acetabular component resulted in loosening of it.


CONCLUSIONS
Medial insertion of the acetabular component provides satisfactory short-term outcomes. Lateral insertion of the acetabular component during total hip arthroplasty should be avoided in patients with marked acetabular dysplasia.
Yamaguchi
T
T
Department of Orthopaedic Surgery, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan. tetsu-y@jf6.so-net.ne.jp
Naito
M
M
Asayama
I
I
Shiramizu
K
K
D000077:Acetabulum / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D016025:Bone Transplantation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005270:Femur Head / Q000637:transplantation*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011379:Prognosis; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D001843:Bone Cements