Total hip replacement with spongious bone graft for acetabular protrusion in patients with rheumatoid arthritis.

Total hip replacement (THR) with the use of autogenous spongious bone graft reinforcement to the medial acetabular wall proved a successful surgical procedure in patients with rheumatoid arthritis and acetabular protrusion. In 25/26 THR followed for an average of 2 (1-4) years, the bone grafts healed in place radiographically and no further protrusion occurred. A non-progressive radiolucent zone of 3 mm at the bone-cement interface occurred around one acetabular cup. Recurrent dislocations occurred in one hip, which eventually turned out to have a loose acetabular cup. One hip with a firmly seated cup was converted to a resection arthroplasty 4 months after the primary operation because of deep infection.