Between 1970 and 1982, cemented total hip replacement without acetabular
bone-grafting was performed on fifty-three patients (sixty-six hips) who
had had severe congenital dysplasia and coxarthrosis. Of these patients,
forty-eight (sixty-one hips) were followed for an average of 8.5 years
(range, two to fourteen years). Two have required a revision procedure
because of deep infection. No revisions have been performed for aseptic
loosening of the prosthesis, but six hips have shown radiographic evidence
of loosening. Inadequate medialization of the acetabular component
increased the incidence of loosening substantially, but variations in the
thickness of the cement, in the volume of cement used, and in the extent of
acetabular coverage were not found to be associated with radiographic
evidence of loosening. We concluded that the addition of a large, solid,
superolateral bone graft above a cemented acetabular component does not
decrease the likelihood of loosening and may increase it.