Fate of bone grafts in acetabular roof reconstructions assessed by roentgenography and scintigraphy

Autogeneic bone grafts--26 femoral heads, four femoral and two iliac bone grafts--were used in 32 total hip arthroplasties, mainly on patients with complete dislocation of the hip, to reconstruct deficiencies of the acetabular roof by a standardized procedure. At the follow-up examination after 24 to 101 months (median, 52 months), roentgenography demonstrated lateral resorption of the graft in 20 of 32 hips, but resorption involved bone support of the socket in only three of the hips. Analysis of serial roentgenograms showed that resorption was not a function of time. Complete incorporation of the grafts was observed in 27 hips; partial incorporation was shown in three. Roentgenographically, two grafts were not incorporated. None of three grafts of a cortical nature was incorporated. Graft uptake of radioactive tracer was found by 99mTc-diphosphonate emission scintigraphy in 16 of 21 hips, but did not correlate with progressive bone resorption, nonunion, or loss of bone structure. High quality serial roentgenograms showing good bone detail provided the best information about the integrity of the acetabular roof reconstructions.