Total hip arthroplasty with bone grafts for protrusio acetabuli.

BACKGROUND This retrospective cohort study analyses the long-term outcomes of total hip arthroplasty (THA) in arthritis patients with various forms of acetabular protrusion. MATERIAL We analyse 135 consecutive cemented total hip arthroplasties in 127 patients. Mean age of the patients was 55.2 years (range: 30-72 years). The study group consisted of 119 women and 16 men who were followed up for a mean of 12.7 years. Mean preoperative function was poor, with a Harris score of 28.0 points. METHODS Clinical evaluation utilized the Harris hip score, and radiographic assessment relied on the criteria of the Joint Committee of the Hip Society, AAOS and SICOT. RESULTS Clinical outcomes of the study group were as follows: excellent in 35 (25.9%), good in 78 (57.8%), fair in 17 (12.6%), and poor in 5 (3.7%). The mean postoperative Harris score was 86.6 points. The radiographic outcomes were excellent in 47 (34.8%), good in 60 (44.5%), fair in 18 (13.3%), and poor in 10 hips (7.4%). Loosening of both components was observed in 6 hips and of the acetabular component in 4 hips. Complications other than aseptic loosening were observed in 25 (18.5%) hips. CONCLUSIONS Implant survival following THA in arthritis with acetabular protrusion depends mainly on proper bone stock reconstruction. 80-85% patients after THA with acetabular bone stock reconstruction achieved very good and good results following an average of 12 years of follow-up. Patients with autogenic bone grafts achieved better outcomes. There was no substantial effect of aetiology, type of endoprosthesis, grade of acetabulum migration on the final outcome.