title: Uncemented acetabular components with femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: a concise follow-up report at a mean of twenty years.
abstract: We previously reported the five to twelve-year results of total hip arthroplasty with an uncemented acetabular component and an autogenous femoral head graft in forty-four consecutive hips with developmental dysplasia. The goal of the present study was to report the implant survival rate, status of bone grafts, and clinical outcomes in thirty-five of these hips (in twenty-nine patients) followed for a mean of 21.3 years. Functional, radiographic, and survivorship results were examined. Radiographic analysis revealed an average cup inclination angle of 43° and a mean arc of cup coverage by the graft of 30°. The twenty-year survivorship free from acetabular revision was 66% (twelve acetabular revisions; eight since our previous report). Of the twelve revisions, nine were for liner wear and/or osteolysis, one was for a liner fracture, one was for aseptic loosening, and one was for instability. All bone grafts healed to the pelvis. The graft facilitated revision cup placement as no additional structural grafts or metal augments were required. We concluded that an uncemented porous-coated socket used in conjunction with a bulk femoral head autograft provides good long-term fixation and restores bone stock.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for M.P. Abdel: abdel.matthew@mayo.edu. E-mail address for R.T. Trousdale: trousdale.robert@mayo.edu. E-mail address for D.J. Berry: berry.daniel@mayo.edu. E-mail address for M.E. Cabanela: cabanela.miguel@mayo.edu.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Abdel
authors.affiliation: Department of Orthopedic Surgery, University of Texas Health Science Center, 7703 Floyd Curl Drive, MC 7774, San Antonio, TX 78229. E-mail address: Stryker@uthscsa.edu.
authors.forename: Louis S
authors.initials: LS
authors.lastname: Stryker
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for M.P. Abdel: abdel.matthew@mayo.edu. E-mail address for R.T. Trousdale: trousdale.robert@mayo.edu. E-mail address for D.J. Berry: berry.daniel@mayo.edu. E-mail address for M.E. Cabanela: cabanela.miguel@mayo.edu.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Trousdale
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for M.P. Abdel: abdel.matthew@mayo.edu. E-mail address for R.T. Trousdale: trousdale.robert@mayo.edu. E-mail address for D.J. Berry: berry.daniel@mayo.edu. E-mail address for M.E. Cabanela: cabanela.miguel@mayo.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Berry
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for M.P. Abdel: abdel.matthew@mayo.edu. E-mail address for R.T. Trousdale: trousdale.robert@mayo.edu. E-mail address for D.J. Berry: berry.daniel@mayo.edu. E-mail address for M.E. Cabanela: cabanela.miguel@mayo.edu.
authors.forename: Miguel E
authors.initials: ME
authors.lastname: Cabanela
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D064592:Autografts / Q000637:transplantation*; D002648:Child; D005260:Female; D005270:Femur Head / Q000637:transplantation*; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult