Total hip arthroplasty with bone graft to the medial acetabular wall was performed on 21 hips in 19 patients with rheumatoid arthritis. Thin slices or block from the femoral head were used as bone graft. Cemented acetabular cup was used in 4 hips and cementless in 17 hips. Ages at operation ranged from 37 to 74 years (mean, 54.1). The postoperative follow-up was done at 3 to 18 months (mean, 9.1). All grafts appeared to have united roentgenographically and the protrusion did not progress. Invasion of cement between the grafted bone and acetabular wall was seen in a patient with cemented acetabular cup. Although non-progressive radiolucent line less than 1mm in width occurred around acetabular cup in 13 hips, no complication has been clinically encountered in a follow-up period. The results of this study suggest that bone graft with cementless cup provides the sufficient medial wall and there is no need for cementing in acetabular cup.
