Bulk Femoral Head Autograft Without Decortication in Uncemented Total Hip Arthroplasty

Superolateral acetabular bone defect is a serious challenge in uncemented total hip arthroplasty for acetabular dysplasia. We report a bulk bone autografting technique without decortication of the acetabulum and femoral head contact surfaces in 22 joints. Mean follow-up time was 8.3 years, and survival rates were 100% for loosening and revision end points. The preoperative Japanese orthopedic association hip score increased from 49.5 to 94.0. Although trabecular bridging and graft remodeling occurred in all cases, complete trabecular reorientation was observed in only 15 joints. Eccentric polyethylene wear was observed in 8 of 22 joints, and osteolysis, in 1 joint. Our technique is easy to perform, and midterm results were favorable; thus, we conclude that it may be an effective option for bulk bone autografting.