Acetabular reconstruction in revision total hip arthroplasty

Acetabular revision surgery is always associated with some degree of bone loss. Where an intact peripheral rim is present it can be used to achieve ingrowth and cementless prosthetic fixation. Where major segmental defects are present and prosthetic stability is not possible in host bone, structural allografts may be necessary to satisfy the principles of acetabular reconstruction. Using quality bone, proper fixation, and buttressing of structural allografts against host bone, a high degree of success can be expected. The majority of acetabular revisions can be reconstructed with large hemispherical sockets and adjuvant screw fixation and the use of bulk allografts should be reserved for those reconstructions where no good alternative exists.