Since 1971 we have used homologous and autogenous bone grafts to
reinforce the medial acetabular wall when doing a total hip replacement in
patients with painful protrusio acetabuli. Thirty-two patients have been
followed for a minimum of two years, the longest follow-up being eight
years. All grafts appeared to have united roentgeno-graphically within
three months, and the protrusion did not progress. In seven patients with a
completely absent medial acetabular wall, a protrusio acetabuli ring was
used to provide support until the bone graft had healed. Complications
included one late dislocation, one pulmonary embolus, two trochanteric
non-unins, two fractured trochanters, and one case of loosening of the
femoral component. The results of this study suggest that bone-grafting is
effective in arresting the progression of acetabular protrusion.