Abstract
BackgroundSevere acetabular deficiencies in cases of developmental dysplasia of the hip (DDH) often require complex reconstructive procedures in total hip arthroplasty (THA). The use of autologous femoral head grafts for acetabular reconstruction has been described, but few data is available about clinical results, the rates of non-union or aseptic loosening of acetabular components.MethodsIn a retrospective approach, 101 patients with 118 THA requiring autologous femoral head grafts to the acetabulum because of DDH were included. Six patients had died, another 6 were lost to follow-up, and 104 hips were available for clinical and radiological evaluation at a mean of 68 ± 15 (13 to 159) months.ResultsThe average Merle d'Aubigné hip score improved from 9 to 16 points. Seven implants had to be revised due to aseptic loosening (6.7%). The revisions were performed 90 ± 34 (56 to 159) months after implantation. The other hips showed a stable position of the sockets without any signs of bony non-union, severe radiolucencies at the implant-graft interface or significant resorption of the graft.ConclusionThe use of autologous femoral head grafts with cementless cups in primary THA can achieve promising short- to midterm results in patients with dysplastic hips.
Highlights
Severe acetabular deficiencies in cases of developmental dysplasia of the hip (DDH) often require complex reconstructive procedures in total hip arthroplasty (THA)
While various shelf procedures have been used for operative treatment of DDH since the last century, Merle d’Aubigné [2] was the first to report on the reconstruction of the deficient acetabular roof, in cases of dysplastic hip joints using a Judet prosthesis and massive autologous bone grafts
In a retrospective approach all THA cases in DDH requiring the use of autologous femoral head grafts at the acetabulum performed at the authors’ institution in a 12-year period were identified from medical records
Summary
Severe acetabular deficiencies in cases of developmental dysplasia of the hip (DDH) often require complex reconstructive procedures in total hip arthroplasty (THA). While various shelf procedures have been used for operative treatment of DDH since the last century, Merle d’Aubigné [2] was the first to report on the reconstruction of the deficient acetabular roof, in cases of dysplastic hip joints using a Judet prosthesis and massive autologous bone grafts. This procedure was later improved in both primary and revision THA [3,4]. The hypotheses were that good short- to midterm results and a low complication rates can be achieved with this operative procedure
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