[Total hip arthroplasty with impaction bone grafting combined with titanium mesh for acetabular bone defect reconstruction secondary to avascular necrosis of the femoral head. Clinical case presentation and literature review].

Avascular necrosis (AVN) of the femoral head is a type of aseptic osteonecrosis caused by the interruption of blood flow to the femoral head, resulting in the cellular death of osteocytes. This pathological process can lead to the degeneration and collapse of the femoral head, causing significant pain and functional disability. Acetabular joint changes or defects begin to be observed in the advanced stages of the disease, following its natural course with advanced joint degenerative changes. In the context of a case of AVN of the femoral head that has progressed to condition an acetabular defect, the placement of a bone graft followed by the placement of a titanium mesh is considered a valid and good therapeutic option, providing both biology and mechanics to the prosthetic construct. We present the case of a 54-year-old male patient with a history of AVN of the femoral head previously treated with total hip replacement of the left hip, who presented to us in an advanced stage of the disease with manifest arthritic changes that have conditioned a predominantly posterior acetabular defect in the right hip. Since we are in an advanced stage of the disease, it was decided to perform a total hip replacement of the right hip, adding the biological component to the acetabular defect by applying both allograft and autograft bone grafts, as well as the placement of a titanium alloy mesh prior to the placement of the acetabular prosthetic component. The entire replacement technique was carried out using uncemented implants.