Surgical treatment of the hip joint with massive skeletal defect is difficult for an orthopaedic surgeon. Bipolar hip prosthesis with massive bone grafting has been done by us on 43 hips of 33 rheumatoid arthritis patients with acetabular protrusion. Partial weight bearing was allowed from 10 days to 3 weeks. Experience has shown that a massive bone graft using extracted femoral head is better than bone fragments as the procedure for acetabular reconstruction.
Adequate bone coverage for the steep acetabular edge was essential for successful reconstruction of 13 secondary displastic hips of 11 patients. Non-weight bearing periods were from 4 to 12 weeks, depending on the amount and site of the grafted bones, as massive bone grafts were very slowly revascularized and incorporated.
The isotope activity was evaluated at the grafted skeletal area of the 12 hips which were examined. All of them showed high activity at the site of grafted bone with in 3 month after surgery. The high activity became less active in 2 patients, in 26 months in one and in 51 months in the another.