Total hip replacement in dysplastic hips using femoral head shelf autografts

A consecutive series of 30 dysplastic hips were treated with total hip arthroplasty using femoral head autograft shelf reconstruction and were reviewed. Cemented cups were used in 13 hips and uncemented cups were used in 17 hips. The average followup was 8.1 years (range, 5.2-13.3 years). In the cemented group, the average preoperative Harris Hip Score was 44.8 points (range, 22-82 points), and in the uncemented group, it was 45 points (range, 23-61 points). At the final review, the average clinical score was 71.5 points (range, 46-98 points) in the cemented group, and in the uncemented group it was 87.5 points (range, 63-100 points). Of the 30 cases, only 3 had unsuccessful results, giving a success rate of 90%. In terms of the autograft, all united to host bone. Resorption, when seen in either cemented or uncemented cups, was minor and restricted to the lateral nonweightbearing part of the graft. The present study supports using shelf autografts to reconstruct dysplastic hips at the time of total hip arthroplasty. In this series, cemented and uncemented cups performed equally well.