Background/Purpose The purpose of this study was to evaluate the clinical and radiographic outcomes of primary cementless total hip arthroplasty (THA) with acetabular defect reconstruction using structural bone grafts. Methods Between 2001 and 2012, 10 hips in eight patients with uncontained superolateral acetabular bone defects were reconstructed with femoral head grafts at the time of primary cementless THA. The mean age at surgery was 61.7 years. Patients were followed-up for a mean of 5.8 years for evaluation. Results With either revision or loosening as endpoints, the survival rate of the structural grafts was 100%. Significant improvements in clinical outcomes in terms of the Visual Analogue Scale for Pain (from 9.5 to 3.3, p = 0.005) and Harris Hip Score (from 32.7 to 73.9, p = 0.005) were noted. Conclusion Uncontained superolateral acetabular bone defects can be effectively reconstructed with structural bone grafts during primary THA, with excellent short- to midterm survival rate and significantly improved clinical outcomes.
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