Outcomes of Two-Stage Autograft Acetabular Reconstruction for Hip Replacement in Young Patients: A Series of 13 Cases

Managing complex hip arthritis in young patients poses significant challenges due to the critical need to preserve bone stock for potential future surgical interventions. Two-stage reconstruction can preserve bone, restore limb length, and address acetabular defects to achieve optimal functional outcomes and facilitate future revisions. Structural autografts offer the dual advantages of reduced infection risk and enhanced initial stability. This study evaluates the surgical outcomes of two-stage autograft reconstruction in the management of young patients with acetabular defects. This case series reports our experience using a two-stage structural autograft approach for acetabular defects in total hip replacement. In the first stage, the acetabular defect is reconstructed using a femoral head autograft, followed by a second-stage hip replacement after eight weeks. A total of 13 patients underwent this surgery, with a mean age of 35 years. Patients were followed up for an average of five years. Good press-fit stability was achieved in all cases. Follow-up plain radiographs showed excellent trabecular bridging between the graft and host bone, with no evidence of graft resorption or acetabular cup loosening. All patients demonstrated good functional outcomes, with no complications such as non-union, infection, or aseptic loosening. Only one patient had sciatic nerve palsy which resolved spontaneously. This technique is an excellent option for treating young patients with sizable acetabular defects. It effectively restores bone stock, provides essential biological stability, and facilitates future revision surgery when necessary.