[Structural Bone Grafting in THR with Cup for Dysplastic Hip.].

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Regenerative Medicine

Context:

• Developmental dysplasia of the hip (DDH) often requires complex surgical solutions.
• Total hip replacement (THR) in dysplastic hips presents unique challenges regarding implant fixation and bone stock.
• Structural bone grafting is a technique used to augment bone defects in hip reconstruction.

Purpose:

• To evaluate the long-term outcomes of cementless CLS cups combined with structural bone grafting in patients with hip dysplasia.
• To assess implant osseointegration, graft healing, and clinical results following this reconstructive approach.

Summary:

• This study reports on 42 patients with hip dysplasia undergoing THR with cementless CLS cups and autogenous femoral head structural grafts, followed for an average of 7.3 years.
• Significant improvement in Harris Hip Scores (37 to 79) was observed. All CLS cups achieved osseointegration, with 100% clinical survivorship and no aseptic loosening or revisions.
• Structural grafts provided an average of 30% support to the cup, demonstrating complete healing with bridging trabeculisation and remodelling at the iliac bone interface.

Impact:

• This reconstructive technique demonstrates a high success rate for cementless THR in dysplastic hips, offering a viable solution for complex cases.
• Successful osseointegration and graft incorporation suggest the potential for durable fixation and long-term implant survival.
• The findings support the use of structural bone grafting in conjunction with cementless implants for improved outcomes in hip dysplasia reconstruction.