Bone-grafting in total hip replacement for acetabular protrusion.

Since 1971 we have used homologous and autogenous bone grafts to reinforce the medial acetabular wall when doing a total hip replacement in patients with painful protrusio acetabuli. Thirty-two patients have been followed for a minimum of two years, the longest follow-up being eight years. All grafts appeared to have united roentgeno-graphically within three months, and the protrusion did not progress. In seven patients with a completely absent medial acetabular wall, a protrusio acetabuli ring was used to provide support until the bone graft had healed. Complications included one late dislocation, one pulmonary embolus, two trochanteric non-unins, two fractured trochanters, and one case of loosening of the femoral component. The results of this study suggest that bone-grafting is effective in arresting the progression of acetabular protrusion.