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Arthroplasty with a solid bone graft for protrusio acetabuli

A W Heywood

    The Journal of Bone and Joint Surgery. British Volume
    |August 1, 1980
    PubMed
    Summary

    This study introduces a novel technique using femoral head grafts to reinforce the medial acetabular wall in rheumatoid arthritis patients undergoing hip replacement. This method prevents component migration and avoids the need for additional fixation devices.

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    Area of Science:

    • Orthopedic Surgery
    • Rheumatology
    • Biomedical Engineering

    Background:

    • Rheumatoid arthritis frequently causes protrusio deformity in hips requiring total joint replacement.
    • Extremely thin medial acetabular walls in these patients pose a risk of acetabular component migration.

    Purpose of the Study:

    • To present a novel surgical technique for reinforcing the medial acetabular wall during total hip replacement.
    • To evaluate the efficacy and safety of using a femoral head graft as a medial wall plug.

    Main Methods:

    • A series of nine hip replacement surgeries were performed on seven patients with rheumatoid arthritis and protrusio deformity.
    • The femoral head was fashioned into a solid graft and anchored against the medial acetabular wall.
    • Postoperative assessment included radiographs, tomograms, and scintigrams.

    Main Results:

    • The femoral head graft served as an effective plug, reinforcing the medial acetabular wall.
    • Satisfactory incorporation of the grafts was observed in serial imaging.
    • No complications were reported during a follow-up period of three months to two years.

    Conclusions:

    • Femoral head grafting is a viable and effective method for reinforcing the medial acetabular wall in total hip replacement for rheumatoid arthritis.
    • This technique minimizes cement usage and eliminates the need for wire mesh or restraining rings.
    • The procedure demonstrates promising outcomes with no observed complications in the short-to-medium term follow-up.

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