To evaluate the clinical and radiographic outcomes of autologous femoral head structural bone grafting in primary total hip arthroplasty (THA) for adult developmental dysplasia of the hip (DDH). A retrospective analysis was conducted on 22 patients (30 hips) with DDH who underwent primary cementless THA utilizing autologous femoral head structural bone grafting between August 2014 and July 2024. Perioperative parameters (operative time, intraoperative blood loss), functional outcomes (Harris Hip Score (HHS)), and radiographic outcomes (vertical and horizontal displacement of the hip rotation center relative to the teardrop, limb length discrepancy (LLD) in unilateral cases, Wiberg center-edge (CE) angle, acetabular component coverage, graft coverage) were quantified. Complications were recorded throughout follow-up. The cohort comprised 5 males and 17 females, mean age 51.73 ± 7.66 years (range: 33–63 years), including 14 unilateral (6 left, 8 right) and 8 bilateral cases. Mean follow-up was 62.4 ± 40.45 months (range: 12–120 months). Mean operative time was 130.67 ± 30.92 minutes (range: 85–195 min); mean intraoperative blood loss was 423.33 ± 253.5 mL (range: 100–1400 mL). The mean HHS improved significantly from 47.77 ± 7.16 preoperatively to 91.20 ± 5.24 at final follow-up (P < 0.0001). Significant restoration of the hip center was achieved: vertical distance decreased from 4.55 ± 1.48 cm to 2.78 ± 0.80 cm, horizontal distance decreased from 6.97 ±1.88 cm to 3.44 ± 0.67 cm (both P < 0.0001). Unilateral LLD was reduced from 25.45 ± 14.05 mm to 5.29 ± 2.91 mm (P ＜ 0.0001). The CE angle increased significantly from 11.53 ± 4.70° to 41.90 ± 4.59° (P < 0.0001). Acetabular component coverage was 96–100% (mean 97.80% ± 1.13%); graft coverage was 19–48% (mean 34.34% ± 7.44%). All grafts demonstrated complete consolidation without collapse or resorption. Surgical incisions healed uneventfully. No complications including periprosthetic infection, loosening, dislocation, or thromboembolic events occurred during follow-up. In primary THA for adult DDH, autologous femoral head structural bone grafting achieves effective biological reconstruction of the hip center, provides high acetabular component coverage, corrects limb length discrepancy, and significantly restores hip function. The technique demonstrated reliable graft osseointegration and favorable clinical outcomes at early- to mid-term follow-up.
Wang et al. (Mon,) studied this question.