Acetabular reconstruction in revision total hip arthroplasty: maximizing function and outcomes in protrusio and cavitary defects. Instructional course lectures Dahl, B., McNeely, C., Robinson, B. S., Maloney, W. J., Paprosky, W. G., Ries, M. D., Saleh, K. J. 2014; 63: 219-225


Osteolysis in the periacetabular region is a common long-term complication of total hip arthroplasty that can lead to bone loss, implant loosening, and protrusio. Several systems have been developed for classifying osteolysis and guiding treatment. Options such as bone grafting or augmentation, with exchange of the bearing surface and, in some cases, revision of the acetabular component, can be used for treatment. Most cavitary and protrusio defects can be treated with a cementless revision cup using screw fixation and grafting with morcellized bone. However, structural augmentation, custom components, or cage reconstruction may occasionally be necessary for managing larger defects with severe loss of acetabular bone stock.

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