{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T15:36:04Z","timestamp":1772292964107,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: The pathologic anatomy of Crowe III is characterized by the erosion of the superior rim of acetabulum, with a typical bone defect in its supero\u2013lateral portion. The performance of a total hip arthroplasty requires the management of the acetabular bone defect, and femoral head autograft can be a valid option to optimize implant coverage. Material and Methods: In all, eight Crowe III patients (nine hips), seven of which having unilateral hip affected, and one with bilateral involvement by secondary osteoarthritis in DDH; maximum limb length discrepancy (LLD) of 3.5 cm in unilateral patients. All were operated on by direct anterior approach. Patients were evaluated in terms of clinical, surgical, and radiological (center-edge, horizontal coverage, cup inclination) parameters. Results: Cup placement was implanted with a mean of 39.5 \u00b1 7.5\u00b0. Stem alignment showed average 1.5 \u00b1 2.3\u00b0 in valgus. LLD showed an overall average preoperative of \u221229.5 \u00b1 10.5 mm at the affected side, with a significant improvement to \u22122.5 \u00b1 6.4 mm (p = 0.023). The mean initial coverage evaluated like a percentage of the horizontal bone host was 52.1 \u00b1 7.1%, while the mean final coverage at the last post-operative X-ray from femoral autograft bone was 97.0 \u00b1 4.5% with an average improvement of 44.5%. Average CE improved from \u22129.5 \u00b1 5.2\u00b0 (CE I) to the immediate post-operative (CE II) of 40.6 \u00b1 8.2\u00b0. At the final follow up, CE III showed a mean of 38.6 \u00b1 6.2\u00b0, with an average decrease of 2.0\u00b0. Discussion: Acetabular bone defect in Crowe III DDH patients undergoing THA by DAA, can be efficiently managed by massive autograft femoral head, which allowed an adequate and long-lasting coverage of the implant, with cup positioning at the native acetabulum.<\/jats:p>","DOI":"10.3390\/jcm12030751","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T03:04:44Z","timestamp":1674011084000},"page":"751","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Femoral Head Autograft to Manage Acetabular Bone Loss Defects in THA for Crowe III Hips by DAA: Retrospective Study and Surgical Technique"],"prefix":"10.3390","volume":"12","author":[{"given":"Cesare","family":"Faldini","sequence":"first","affiliation":[{"name":"Ist Orthopaedic Department, IRCCS\u2014Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Science\u2014DIBINEM, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9376-5480","authenticated-orcid":false,"given":"Matteo","family":"Brunello","sequence":"additional","affiliation":[{"name":"Ist Orthopaedic Department, IRCCS\u2014Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Science\u2014DIBINEM, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Pilla","sequence":"additional","affiliation":[{"name":"Ist Orthopaedic Department, IRCCS\u2014Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9640-5031","authenticated-orcid":false,"given":"Giuseppe","family":"Geraci","sequence":"additional","affiliation":[{"name":"Ist Orthopaedic Department, IRCCS\u2014Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Science\u2014DIBINEM, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5648-8031","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Stefanini","sequence":"additional","affiliation":[{"name":"Ist Orthopaedic Department, IRCCS\u2014Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Science\u2014DIBINEM, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3834-6798","authenticated-orcid":false,"given":"Leonardo","family":"Tassinari","sequence":"additional","affiliation":[{"name":"Ist Orthopaedic Department, IRCCS\u2014Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Science\u2014DIBINEM, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0716-4951","authenticated-orcid":false,"given":"Alberto","family":"Di Martino","sequence":"additional","affiliation":[{"name":"Ist Orthopaedic Department, IRCCS\u2014Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Science\u2014DIBINEM, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2106\/00004623-197961010-00004","article-title":"Total hip replacement in congenital dislocation and dysplasia of the hip","volume":"61","author":"Crowe","year":"1979","journal-title":"J. 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