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British Journal of Medical and Health Research

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Cemented Total Hip Arthroplasty in Protrusio Acetabuli in Rheumatoid Arthritis Using Impacted Morselized Bone Grafting and Wire Mesh: A Novel Technique with Literature Review

Published in June 2026 Issue 6 (Vol. 13, Issue 6, 2026)

Cemented Total Hip Arthroplasty in Protrusio Acetabuli in Rheumatoid Arthritis Using Impacted Morselized Bone Grafting and Wire Mesh: A Novel Technique with Literature Review - Issue cover

Abstract

Abstract Introduction Protrusio acetabuli secondary to rheumatoid arthritis (RA) presents a complex reconstructive challenge during total hip arthroplasty (THA), particularly in the presence of medial wall deficiency and osteoporotic bone. Restoration of hip biomechanics and medial support is essential to prevent cup migration and recurrence of protrusion. Case Report A 75-year-old female with long-standing RA presented with bilateral end-stage hip arthritis and advanced protrusio acetabuli. Radiographs demonstrated Tönnis grade 3 osteoarthritis and Sotelo-Garza grade 3 (left) and grade 2 (right) protrusio. Intraoperatively, Paprosky Type 2C medial wall defects were identified. Staged bilateral cemented THA was performed using titanium mesh and impacted morselized autologous femoral head graft prior to cementation of the acetabular component. Results At five-year follow-up, radiographs demonstrated graft incorporation and restoration of the hip center without evidence of cup migration or loosening. Harris Hip Score improved from 36 preoperatively to 86 at final follow-up. Conclusion Titanium mesh combined with impacted autologous cancellous graft provides a biologically favorable and cost-effective option for medial wall reconstruction in rheumatoid protrusio acetabuli undergoing cemented THA.

References

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Authors (6)

Bikram Keshari Kar

All India Institute of Medical...

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Shivam Chauhan

All India Institute of Medical...

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Devashish Singh

Sanjay Gandhi Postgraduate In...

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Dushyant Chouhan

All India Institute of Medical...

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Jayakrishnu tj

All India Institute of Medical...

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Rudra Narayan Dash

All India Institute of Medical...

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Article Information

BJMHR6130009

BJMHR-13-000031

87-93

2026-06-23

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How to Cite

Keshari, B., & Chauhan & Singh & Chouhan & tj & Narayan, R. (2026). Cemented Total Hip Arthroplasty in Protrusio Acetabuli in Rheumatoid Arthritis Using Impacted Morselized Bone Grafting and Wire Mesh: A Novel Technique with Literature Review. British Journal of Medical and Health Research, 13(6), 87-93. https://bjmhr.com/articles/BJMHR6130009

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