Short-term results of primary total hip arthroplasty for Protrusio Acetabuli

BACKGROUND AND PURPOSE: Protrusio is a central acetabular defect resulting from migration of the femoral head medial to Kohler’s line. Protrusio can develop in association with a number of conditions that affect the metabolism or mechanical behavior of the periacetabular bone. Total hip arthroplasty (THA) for acetabular protrusio requires reconstruction of the contained cavitary defect. The purpose of this study is to assess the outcome of primary total hip replacement in this category of patients using impacted autograft with either cemented or cementless cups. METHODS: Our Prospective study was carried out during the period from January 2010 to January 2013. We reported 8 hips in 6 patients (4 males and 2 female) with age ranged from 54 to 73 years (mean age 64 years) and presented to our department with protrusio acetabuli (5 patients had primary protrusio acetabuli and 1 patient had secondary protrusio acetabuli). Using the Sotelo-Garza and Charnley classification of protrusio acetabulai, two hips had garde I (mild) protrusio ,three had grade II (moderate) and three had garde III protrusion (severe). In 5 cases a cementless prosthesis was used and cemented prosthesis were used in 3 cases. In one case a bursh-schneider cage of the acetabulum was added. Radiographic and clinical follow-up was performed up to 4 years postoperatively (mean follow-up 16 months, range 12-49 months). RESULTS: At radiographic follow-up, no signs of prosthetic loosening or migration were seen. Harris Hip Score improved from 25.8 (SD 7.3, range 11-34) preoperatively to 88.3 (SD 9.7, range 71-98) at latest follow-up. CONCLUSION: primary total hip replacement using impacted autograft in patients with protrusio acetabuli led to a good result in a series of eight cases at short term follow-up.