Major acetabulum reconstruction using autograft bone in cemented hip arthroplasty

Acetabular wall deficiency is a relatively common problem in prosthetic hip arthroplasty. The authors have reviewed the results of acetabular reconstruction using autogenous bone grafts, either iliac wing or femoral head, in 49 cases in which a cemented acetabular component was employed. Thirty-one were primary cases, 15 revisions, and 3 ankylosed hips. The roof only was deficient in 20, the anterior wall in five, and the posterior wall in one. Fourteen had combined deficiencies and nine had total acetabular deficiency. Follow up ranged from three to eight years. The results have been reasonable with no graft absorption and no early acetabular component loosening. Failure of the femoral side in one case of total acetabular reconstruction at four years led to revision. The bone grafts were found to be united and had re-established a normal blood supply. It is concluded that autogenous bone grafting of the acetabulum is a reasonable procedure.