Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 27:44:102247.
doi: 10.1016/j.jcot.2023.102247. eCollection 2023 Sep.

Protrusio acetabuli in tubercular hip: Outcome of femoral head as autologous bone graft used during total hip replacement

Narendra Singh Kushwaha  1 , Arpit Singh  1 , Atul Kumar Saroj  2 , Ashutosh Verma  1 , Khurshid Alam Ansari  1
Affiliations

Protrusio acetabuli in tubercular hip: Outcome of femoral head as autologous bone graft used during total hip replacement

Narendra Singh Kushwaha et al. J Clin Orthop Trauma. .

Abstract

Purpose: Here we present a study of a tuberculosis hip protrusion with a large acetabular defect treated by total hip replacement using a novel technique without the use of any protrusio ring, wire mesh, or cage. To our knowledge, such a technique has not been described in the literature previously.

Methodology: 25 patients with a past treatment history of hip tuberculosis came to our medical college with complaints of worsening pain in the hip joint and limping. The hip pain and limping were progressive in nature and became more severe, and his affected lower limb shortened.

Results: The average AK distance (horizontal distance between Kohlar line and the medial acetabular border) before surgery was 8 mm (range: 1-16). For the acetabular implant, the mean abduction angle was 45° (range: 41-48), and the mean anteversion angle was 18° (range: 13-24). The average preoperative shortening for limb length inequality was 4 mm (range: 0-11). The average HHS (Harris Hip Score) during follow-up was 87.6 points.

Conclusion: In TB hip protrusio, an autograft of the femur head is used to fill the acetabular defect and provide a good approach for these patients without any extra economic burden or complications as seen in a metallic ring or cage.

Keywords: Autologus femoral head autograft; Protrusio acetabuli; Tubercular hip.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Pre op x-ray showing protrusion acetabuli of right hip.
Fig. 2
Fig. 2
Removed head after neck osteotomy.
Fig. 3
Fig. 3
Morselized femoral head autograft.
Fig. 4
Fig. 4
Prepared acetabulum after impaction femoral head autograft.
Fig. 5
Fig. 5
Immediate post operative x-ray.
Graph-1
Graph-1
Complications found during follow up.
See this image and copyright information in PMC

References

    1. Saraf S.K., Tuli S.M. Tuberculosis of hip: a current concept review. Indian J Orthop. 2015 Feb;49:1–9. doi: 10.4103/0019-5413.143903. - DOI - PMC - PubMed
    1. Welten M.L., Schreurs B.W., Buma P., Verdonschot N., Slooff T.J. Acetabular reconstruction with impacted morcellized cancellous bone autograft and cemented primary total hip arthroplasty: a 10-to 17-year follow-up study. J Arthroplasty. 2000 Oct 1;15(7):819–824. doi: 10.1054/arth.2000.7110. - DOI - PubMed
    1. Yun A., Qutami M., Carles E. Managing protrusio acetabuli with a direct anterior approach total hip replacement. Cureus. 2021 Mar 22;13(3) doi: 10.7759/cureus.14048. - DOI - PMC - PubMed
    1. Zhen P., Li X., Zhou S., Lu H., Chen H., Liu J. Total hip arthroplasty to treat acetabular protrusions secondary to rheumatoid arthritis. J Orthop Surg Res. 2018 Dec;13:1–7. doi: 10.1186/s13018-018-0809-y. - DOI - PMC - PubMed
    1. Nilsdotter A., Bremander A. Measures of hip function and symptoms: Harris hip score (HHS), hip disability and osteoarthritis outcome score (HOOS), Oxford hip score (OHS), Lequesne index of severity for osteoarthritis of the hip (LISOH), and American Academy of orthopedic surgeons (AAOS) hip and knee questionnaire. Arthritis Care Res. 2011 Nov;63(S11):S200–S207. doi: 10.1002/acr.20549. - DOI - PubMed

LinkOut - more resources