Uncemented total hip arthroplasty with superior acetabular deficiency: Femoral head autograft technique and early clinical results

A technique for primary uncemented total hip arthroplasty in the presence of a superolateral acetabular deficiency is described. The resected femoral head is used as an autograft. Matching reamers are used to ream the pseudoacetabulum and femoral head. Lag screw fixation is then performed and reaming of the graft and host bone simultaneously allows placement of an uncemented acetabular component. The hip center of rotation is returned to its anatomic center, the medial wall and subchondral bone are maintained, maximal contact and rigid fixation is obtained between femoral head autograft and host bone, and press fit of an uncemented cup is achieved. This method was applied to 10 consecutive hips in seven patients who had superior migration of the femoral head. The results were compared to those of 44 uncomplicated primary uncemented total hip arthroplasties during the same time period. While operative time and blood loss were increased in the bone graft cases, the early clinical results were equivalent to those of routine uncemented total hip arthroplasties.