The use of femoral head autograft shelf reconstruction and cemented acetabular components in the dysplastic hip.

In view of the controversy about bulk autografts to provide support for the acetabular cup in reconstruction of the dysplastic hip, a series of 15 dysplastic hips were investigated as follows: Femoral head autograft shelf reconstruction and cemented acetabular components were evaluated at an average follow-up period of 99 months after operation (range, 27-141 months). Hip rating scores and radiographic assessments were done on each patient before surgery and at postoperative examinations. The average preoperative hip score was 43.6 points (range, 22-82). The average hip score at review was 72.3 points (range, 48-100). The increase in hip scores was 29 points (range, -10 to +69). All grafts showed radiographic evidence of union to the pelvis at review. There was no resorption in five cases. The graft showed some resorption in eight cases, six of which were minor. None of the grafts or the acetabular components showed any signs of migration. Although the number of cases is small, the results show that bulk acetabular allografts can survive beneath cups in reconstructed dysplastic hips.