Assessment of Supero-Lateral Bulk Bone Grafts in Total Hips using Radiographs and Scintigraphy

Incorporation of autologous bulk grafts in dysplastic acetabula may be difficult to confirm radiologically. In our series twelve consecutive patients (fifteen hip replacements) were assessed between two and seven years from the time of surgery. All the femoral heads used for bulk autografting showed radiological evidence of cross trabeculation in the load bearing zone of the acetabulum. To confirm the radiological impression of incorporation and consolidation scintigraphy was carried out on 11 out of 12 patients. 5 patients also had tomograms of their graft-host interface. Radiologically resorption of these bulk grafts occurred at the lateral non-weight bearing edge of the graft in a number of patients. Scintigraphy confirmed block graft incorporation in all patients. Tomograms were not found to be a useful assessment of the incorporation of the supero-lateral bulk graft. An indirect measurement of acetabular migration showed no significant migration of the acetabular component over the period of follow up in all patients.