Femoral head autografting with total hip arthroplasty for lateral acetabular dysplasia. A 12-year experience.

The use of a lateral femoral head autograft with total hip arthroplasty is an effective method to treat moderate to severe acetabular dysplasia with an excellent chance of satisfactory results. The operation was performed on 42 hips in 37 patients over a 12-year period. The average follow-up period was 5.7 years, with none shorter than two years. A posterior approach was used with no trochanteric osteotomy in 38 hips. Average operative time was 133 minutes and average blood replacement was 435 ml. All grafts united. Average Harris hip ratings increased from a preoperative 39.1 points to a postoperative 89.8 points. Complications included three loose femoral components (one definite, one probable, and one possible), two loose acetabular components (one definite and one possible), one Class IV heterotopic ossification, and two cases of thrombophlebitis. Two patients required revision surgery for loosening. To date, there are no infections, dislocations, pulmonary emboli, nerve palsies, or deaths.