Structural bone allograft versus titanium trabecular augment in management of Paprosky type III acetabular defects in total hip arthroplasty: A pilot study

Objectives: The objective of the study is to compare the radiological and clinical outcomes of structural bone allografts versus trabecular titanium augments in managing Paprosky type III acetabular defects during total hip arthroplasty (THA). Methods: A randomized controlled trial was conducted from February 2021 to February 2023. Thirty cases were equally randomized into two groups: Group A received trabecular titanium augments, and Group B received structural femoral head allografts. Results: No substantial differences were identified between groups concerning age, sex, or existing comorbidities. Notably, the Harris Hip Score was significantly greater in the titanium augment group at 6 weeks ( P < 0.001) and 1 year ( P = 0.001) following surgery, while no significant difference was detected preoperatively or at 6 months, while no variations were detected at the pre-operative stage or at the 6-month mark. There were also no significant disparities in operative time, intraoperative blood loss, or post-operative complications, including deep vein thrombosis, dislocation, heterotopic ossification, and superficial wound infection. Likewise, radiographic outcomes showed no significant differences in bone ingrowth, restoration of the hip center, or signs of component loosening. Conclusion: Trabecular titanium augments demonstrated superior early and mid-term functional outcomes compared with structural bone allografts in the management of Paprosky type III acetabular defects during THA.