Bulk autograft for a deficient acetabulum in Charnley low-friction arthroplasty. A 2-9-year follow-up study.

Abstract

The authors assessed 40 hips in 36 patients where a bulk femoral head autograft was used to supplement deficient acetabulum while performing Charnley low-friction arthroplasty. The majority of the hips were congenitally dysplastic or dislocated with secondary arthritis. The average age at surgery was 47.5 years and the average follow-up period was 4 years. The graft provided a cover between 10 and 42% (mean, 23%) of the socket hemisphere. Union of the graft was evident on the radiograph in 35 hips. There was no graft resorption in 28 hips. Mild graft resorption was seen in 11 cases, and moderate graft resorption was seen in 1 case. In 24 cases, there was no demarcation at the bone-cement interface of the socket. Asymptomatic demarcation of 1 mm thickness or less was seen in 16 hips, of which only 2 showed demarcation at the cement-graft interface. All 40 cases were clinically asymptomatic and successful thus far, with the mean d'Aubigne and Postel score improving from 3.1, 2.8, and 2.9 before surgery to 5.9, 5.4, and 4.9 after surgery for pain, function, and movement, respectively.