Impacted morsellized bone grafting and cemented primary total hip arthroplasty for acetabular protrusion in patients with rheumatoid arthritis: An 8- to 18-year follow-up study of 36 hips

Between 1979 and 1989, we performed 36 primary total hip replacements in 31 rheumatoid arthritis patients with protrusio acetabuli. The deficient acetabulum was reconstructed with autologous morsellized bone grafts from the femoral head. 3 patients were lost to follow-up. 12 patients (13 hips) died within 8 years postoperatively, none had a revision. 16 patients (20 hips) were reviewed at an average follow-up of 12 (8-18) years. In 2 hips, a revision was performed for aseptic loosening of the acetabular component, 6.5 and 8 years after primary surgery, which means a 90% (95% CI: 77%-100%) survival rate at 12 years (Kaplan Meier analysis). This technique is a good option in cases with protrusio acetabuli due to rheumatoid arthritis.