Autogenous impaction grafting in total hip arthroplasty with developmental dysplasia of the hip

Autogenous impaction grafting was performed to improve acetabular cup coverage in 68 patients (78 hips) with developmental dysplasia of the hip (DDH) after total hip arthroplasty, and the patients were then monitored for a mean duration of 5.5years. No cup revisions were required, and there was no radiographic loosening. The host-graft interface became indistinct by 6weeks after surgery, trabecular bone formation was seen by 12weeks, and definite trabecular reorientation was seen by 20months. At the last follow-up examination, the mean cup coverage was 97.7%, whereas mean coverage by bone grafting was 27.9%. Among 12 patients with most of the bone graft placed at the absolutely protruded area of the cup, the cup coverage provided by the bone graft decreased from 95.4% immediately after surgery to 20.7% by the final follow-up examination. Bone-particle grafting can provide a satisfactory integration speed and a low incidence of displacement and ectopic ossification.