Coxarthrosis after congenital dysplasia. Treatment by total hip arthroplasty without acetabular bone-grafting

Between 1970 and 1982, cemented total hip replacement without acetabular bone-grafting was performed on fifty-three patients (sixty-six hips) who had had severe congenital dysplasia and coxarthrosis. Of these patients, forty-eight (sixty-one hips) were followed for an average of 8.5 years (range, two to fourteen years). Two have required a revision procedure because of deep infection. No revisions have been performed for aseptic loosening of the prosthesis, but six hips have shown radiographic evidence of loosening. Inadequate medialization of the acetabular component increased the incidence of loosening substantially, but variations in the thickness of the cement, in the volume of cement used, and in the extent of acetabular coverage were not found to be associated with radiographic evidence of loosening. We concluded that the addition of a large, solid, superolateral bone graft above a cemented acetabular component does not decrease the likelihood of loosening and may increase it.