Protrusio acetabuli in tubercular hip: Outcome of femoral head as autologous bone graft used during total hip replacement.

Purpose: Here we present a study of a tuberculosis hip protrusion with a large acetabular defect treated by total hip replacement using a novel technique without the use of any protrusio ring, wire mesh, or cage. To our knowledge, such a technique has not been described in the literature previously. Methodology: 25 patients with a past treatment history of hip tuberculosis came to our medical college with complaints of worsening pain in the hip joint and limping. The hip pain and limping were progressive in nature and became more severe, and his affected lower limb shortened. Results: The average AK distance (horizontal distance between Kohlar line and the medial acetabular border) before surgery was 8 mm (range: 1-16). For the acetabular implant, the mean abduction angle was 45° (range: 41-48), and the mean anteversion angle was 18° (range: 13-24). The average preoperative shortening for limb length inequality was 4 mm (range: 0-11). The average HHS (Harris Hip Score) during follow-up was 87.6 points. Conclusion: In TB hip protrusio, an autograft of the femur head is used to fill the acetabular defect and provide a good approach for these patients without any extra economic burden or complications as seen in a metallic ring or cage.