Is Autologous Femoral Head Augmentation Still an Effective Method in the Reconstruction of Complex Acetabular Defects in Patients with Neglected Developmental Dysplasia of the Hip? A Comprehensive Discussion with Radiographic Assessment and Surgical Technique.

Total hip arthroplasty (THA) is a transformative procedure in addressing hip arthritis. However, managing acetabular defects remains challenging, particularly in neglected developmental dysplasia of the hip cases due to altered hip anatomy. A middle-aged female presented with bilateral hip arthritis secondary to dysplasia. She was planned for staged bilateral THA. Intraoperatively, we noted a shallow acetabulum with a posterior superolateral defect and significant uncoverage of the cup. The defect was reconstructed using autologous femoral head graft and screws fixation along with contracture releases. Postoperative bilateral outcome scores showed significant improvement at 6 months and 2 years, with neutral limb length discrepancy. Follow-up radiographs showed successful graft integration and implant stability. This technique offers the advantages of biological integration, improved implant stability, enhanced joint survivorship, and improved quality of life. In situations, where acetabular augments are unavailable or cannot be used owing to financial constraints, this technique proved to be an effective method.