ABSTRACT
Introduction: A lack of bone stock, deficient medial cupsupport and medial & proximal migration of the joint centerare the main challenges in treating cases of protrusio acetabuliwith end stage arthritis. The purpose of this prospective studywas to assess the functional outcome, radilogical parameters& complications related to uncemented total hip arthroplastyin these patients.Material and methods: From November2017 to December2019, 20 patients (33 hips) with secondary acetabularprotrusions (25 grade II & 8 grade I) with end stage arthritisunderwent uncemented total hip arthroplasties with or withoutautologous bone grafting. The Harris hip scoring systemwas used to evaluate hip function during follow-up. X-rayswere taken to assess the prosthesis loosening, bone grafthealing, cup inclination angle & comparing various pre andpostoperative radiological parameters.Results: The operation time ranged from 60 to 120 min (mean=77.12 ± 14 min). The blood loss was 200 to 400 mL (mean= 252 ± 49.5 mL). The average follow-up duration was 1.5years (range 6m-2yrs). Postoperative X-rays revealed bonegraft union at 6 months post-surgery. The Harris hip scoresincreased from 34.07 ± 11.43 to 86.22 ± 6.85 postoperativelythat was statistically significant (P < 0.01). The distance fromthe center of the femoral head to Kohler’s line increasedfrom 18.76 ± 3.7 mm to 20.4 ± 3.3 mm after the operation(P < 0.01). During follow-up, no hip acetabular prosthesisloosening & progression of protrusio was evident.There wasno dislocation but one case of infection and one case of sciaticnerve injury as postoperative complication.Conclusion: The use of impacted or unimpacted morselizedautograft in conjunction with porous-coated cementlessacetabular components was a technically straight forwardsolution through which the hip bio mechanics were restoredand strong fixation was achieved, thereby preventingrecurrence of protrusio in grade II or III. For grade I protrusiowith end stage arthritis only uncement THR without bonegraft was adequate.