Cementless total hip arthroplasty with femoral head bone grafting for hip dysplasia

Femoral head bone grafting was required to augment acetabular bone stock in 19 cases of hip dysplasia treated with cementless total hip arthroplasty. All acetabular grafts provided mechanical support for the cementless acetabular component. Radiographic evaluation of the fixation of the femoral components at an average of 3 years after surgery revealed an optimum appearance in all cases. All porous-coated acetabular components remained stable, but only one of six (17%) nonporous threaded acetabular components maintained stability. One threaded acetabular component has been revised for symptomatic loosening. Acetabular graft healing was suspected in 18 of 19 cases (95%). Significant graft resorption was observed only in the cases with unstable threaded acetabular components. The clinical scores were high. Cementless total hip arthroplasty with structural acetabular grafting and porous acetabular components appears to produce satisfactory short-term results.