Bone grafting in total hip replacement for acetabular protrusion

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Hip protrusion, often caused by arthrosis, rheumatoid arthritis, or trauma, presents complex reconstructive challenges.
• Acetabular defects require specialized surgical techniques to restore hip joint stability and function.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of total hip replacement combined with acetabuloplasty for hip protrusion.
• To assess the efficacy of various acetabuloplasty techniques, including bone grafts and implants, in managing acetabular defects.

Main Methods:

• Surgical intervention involved total hip replacement and acetabuloplasty in 43 hips across 40 patients.
• Acetabuloplasty techniques included medial wall reinforcement using bone grafts, vitallium meshes, protrusion rings, and cups, tailored to individual acetabular defects.

Main Results:

• Uniformly good clinical and radiographic results were observed at an average 2-year follow-up.
• All bone grafts showed successful union and incorporation without resorption.
• One patient experienced pain, correlated with radiographic signs of progressive varus migration of the femoral component.

Conclusions:

• Total hip replacement with acetabuloplasty is a successful treatment for hip protrusion.
• Acetabuloplasty techniques utilizing grafts and implants provide stable and durable reconstructions.
• Monitoring for femoral component migration is crucial for long-term outcomes.