FEMORAL-HEAD BONE-GRAFTING FOR RECONSTRUCTION OF THE ACETABULAR WALL IN DYSPLASTIC HIP-REPLACEMENT

From 1980 through 1991 we screwed a preshaped cortico-cancellous bone graft onto the ileum wall to compensate acetabular deficiency in 94 co nsecutive total hip replacements. We report the results of 87 hips (79 patients) with an average follow-up of 30 months (12-75 months) posto peratively. Pain in dysplasia-coxarthrosis and congenital dislocation of the hip, destructive coxitis in rheumatoid arthritis and cup loosen ing was the main indication for surgery. According to the Merle d'Aubi gne score the postoperative clinical evaluation demonstrated 77% very good and 18% good results. Due to component loosening the results had to be classified as unsatisfactory in 4 hips (2 cups and 2 stems). At the time of evaluation 90% of the arthroplasties was osseously consoli dated as evidenced by trabecular bridging and structural integrity wit h host bone. Resorptions of the graft were noted in 32 hips. One cup w as removed because of complete resorption and consecutive loosening, a further one was considered clinically and radiologically loose becaus e of partial graft resorption. Two further complete resorptions and 28 partial lateral resorptions had no influence on the secondary stabili ty of the implant. We are aware that these are short-term results. Nev ertheless, we recommend the described method as a valuable addition to arthroplasties for acetabular rim defects both in osteoarthritis and in revision surgery.