Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review

Thirty primary total hip arthroplasties were performed for protrusio acetabuli in 23 patients (mean age, 46 years) using impacted autologous bone grafting and a cementless porous-coated hemispheric cup without the use of metal cages or rings. At 2 to 10 years' follow-up (mean, 4.2 years), there was satisfactory radiographic evidence of consolidation of the graft in all cases. All acetabular components were considered to be stable with no instance of graft resorption. Clinical results were considered as excellent in 14 hips, good in 13 hips, fair in 2 hips, and poor in 1 hip. For younger patients with protrusio acetabuli, use of an uncemented porous-coated hemispheric cup with peripheral press-fit fixation and restoration of bone stock with impacted autologous bone grafting reflect a technically straightforward procedure that appears to give satisfactory medium-term results.