Femoral head autograft preparation during hip arthroplasty - A technical refinement

Abstract

Acetabular bone grafting is sometimes required during total hip arthroplasty following congenital dislocation of the hip or to address protrusio and specific techniques have been well described (1-4). Autograft is generally prepared following femoral head removal (2). The technique can be technically demanding, as extra assistance is frequently needed to hold the head in position, making operation of the ossilating saw and other surgical tools difficult. This may increase surgical time and risk accidental injuries to personnel. Moreover, preperation generally occurs away from the main surgical field, risking contamination. Inappropriate contouring of the graft may also occur. We describe a technique that has been used for many years by senior author (s. şükrü Araç) in which the femoral head is contoured ‘in situ’ (before femoral neck osteotomy) using using appropriate instruments. Accurate dimensions can be achieved to address either the acetabular insufficiency or central defect determined by preoperative radiographs (Figure 1). After contouring, the femoral neck is osteotomized.