Total hip replacement and femoral-head bone-grafting for severe acetabular deficiency in adults.

We performed total hip replacement in twenty-seven hips of twenty-two patients with osteoarthritis secondary to congenital dislocation, congenital dysplasia, or acetabular insufficiency due to persistent fracture-dislocation. The femoral head was used as a bone graft, attaching it to the acetabular wall to provide bone stock for reconstruction. There were few postoperative complications. In thirteen hips followed for over one year, all grafts appeared to be united and none showed evidence of resorption. Eleven of the thirteen hips were pain-free and two were slightly painful. Eleven hips had a range of motion of 90 degrees or more.