Objective: To evaluate the outcomes of total hip arthroplasty (THA) for osteoarthritis with serious sclerosing acetabulum bone with acetabular reconstruction of a mesh technology with a femoral head autograph. Methods: A retrospective study was made on 21 hips in 19 patients (12 male and 7 female: average age, 67 years) with osteoarthritis of hip treated by THA with use of a mesh technology. The average follow-up period was 3 years (range, 24~60 months). An patients were evaluated with the use of a Harris hip score and Hospital for Special Surgery Hip Replacement Expectations Survey. Radiographic evaluations were made by preoperative and followup. Results: All autografts were seen to be united to host-bone. No collapse of the autograft and no hip had the evidence of loosening of component seen in all patients. According to the Hospital for Special Surgery Hip Replacement Expectations Survey, the average postoperative satisfaction was 89 at the final review. According to the Harris hip score, the average Harris hip score increased from 51 at preoperation to 88 at 2 years of follow-up. Conclusion: THA with use of an mesh technology in conjunction with a femoral head autograft for osteoarthritis with serious sclerosing acetabulum bone could obtain favorable results. This method could provide reliable acetabular fixation and appeared to restore a cetabular bone stock in patients with osteoarthritis with serious sclerosing acetabulum bone.