Reinforcement rings with hook in acetabular reconstruction

Acetabular osteolysis associated with socket loosening is one of the main long-term complications of total hip arthroplasty. In the case of major bone loss where less than 50% host bone coverage can be obtained with a porous-coated cementless cup, it is generally agreed that a metal ring in association with a cemented component and allograft bone should be used. Herein we describe the technical details of the use of the Kerboull acetabular reinforcement device and the GAP cup. Both these devices have a hook that has to be placed under the teardrop of the acetabulum and a plate for iliac fixation. The main advantages of these devices are their help in restoring the normal hip center of rotation, guiding the reconstruction, and partially unloading the graft. The Kerboull acetabular reinforcement device has provided a 92% survival rate free of loosening at 13-year follow-up in a consecutive series of 60 type III and IV deficiencies.