Position of the acetabular component determines the fate of femoral head autografts in total hip replacement for acetabular dysplasia
- 1 July 2007
- journal article
- research article
- Published by British Editorial Society of Bone & Joint Surgery in The Journal of Bone and Joint Surgery. British volume
- Vol. 89 (7), 874-878
- https://doi.org/10.1302/0301-620x.89b7.18417
Abstract
We have reviewed 54 patients who had undergone 61 total hip replacements using bulk femoral autografts to augment a congenitally dysplastic acetabulum. There were 52 women and two men with a mean age of 42.4 years (29 to 76) at the time of the index operation. A variety of different prostheses was used: 28 (45.9%) were cemented and 33 (54.1%) uncemented. The graft technique remained unchanged throughout the series. Follow-up was at a mean of 8.3 years (3 to 20). The Hospital for Special Surgery hip score improved from a mean of 10.7 (4 to 18) pre-operatively to a mean of 35 (28 to 38) at follow-up. The position of the acetabular component was anatomical in 37 hips (60.7%), displaced less than 1 cm in 20 (32.7%) and displaced more than 1 cm in four (6.6%). Its cover was between 50% and 75% in 34 hips (55.7%) and less than 50% in 25 (41%). In two cases (3.3%), it was more than 75%. There was no graft resorption in 36 hips (59%), mild resorption in 21 (34%) and severe resorption in four (6%). Six hips (9.8%) were revised for aseptic loosening. The overall rate of loosening and revision was 14.8%. Overall survival at 8.3 years was 93.4%. The only significant factor which predicted failure was the implantation of the acetabular component more than 1 cm from the anatomical centre of rotation of the hip.Keywords
This publication has 19 references indexed in Scilit:
- Cemented total hip arthroplasty with autogenous acetabular bone grafting for hips with developmental dysplasia in adultsThe Journal of Bone and Joint Surgery. British volume, 2000
- Medial Protrusio Technique for Placement of a Porous-Coated, Hemispherical Acetabular Component without Cement in a Total Hip Arthroplasty in Patients Who Have Acetabular Dysplasia*The Journal of Bone & Joint Surgery, 1999
- Bone—graft augmentation for acetabular deficiencies in total hip arthroplasty: Results of long-term follow-up evaluationThe Journal of Arthroplasty, 1997
- Bulk Structural Autogenous Grafts and Allografts for Reconstruction of the Acetabulum in Total Hip Arthroplasty. Sixteen-Year-Average Follow-up*The Journal of Bone & Joint Surgery, 1997
- The Effect of Superior Placement of the Acetabular Component on the Rate of Loosening after Total Hip Arthroplasty. Long-Term Results in Patients Who Have Crowe Type-II Congenital Dysplasia of the Hip*The Journal of Bone & Joint Surgery, 1996
- Congenital Hip Disease in Adults. Classification of Acetabular Deficiencies and Operative Treatment with Acetabuloplasty Combined with Total Hip Arthroplasty*The Journal of Bone & Joint Surgery, 1996
- Autogenous bone grafts from the femoral head for the treatment of acetabular deficiency in primary total hip arthroplasty with cement. Long-term results.The Journal of Bone & Joint Surgery, 1995
- High placement of porous-coated acetabular components in complex total hip arthroplastyThe Journal of Arthroplasty, 1994
- Failure of acetabular autogenous grafts in total hip arthroplasty. Increasing incidenceThe Journal of Bone & Joint Surgery, 1990
- Low-Friction Arthroplasty in Congenital Subluxation of the HipClinical Orthopaedics and Related Research, 1973