Reconstruction options for acetabular revision

Table 1 Paprosky classification system for acetabular defects[26]

	Description
Type	Superior hip center migration	Is chialosteolysis	Kohler line	Teardrop
I	Minimal	None	Intact	Intact
IIA	Mild	Mild	Intact	Intact
IIB	Moderate	Mild	Intact	Intact
IIC	Mild	Mild	Disrupted	Moderate lysis
IIIA	Severe	Moderate	Intact	Moderate lysis
IIIB	Severe	Severe	Disrupted	Severe lysis

Table 2 Reconstruction options for acetabular revision

Acetabular revision option	Clinical pearls
Isolated liner exchange	The stability and orientation of the acetabular metal component should be confirmed at the time of revision, liner may be cemented if needed
Hemispheric porous-coated cup	May be used in conjunction with adjunct techniques of bone grafting, screw fixation recommended
Highly porous metal cup	Appears to be effective in achieving biologic fixation in cases of severe bone defects, augments may be used for structural support, cup-cage construct can be used to offload cup
Antiprotrusio cage	Useful in cases of severe bone defects or pelvic discontinuity, spans areas of healthy host bone and accommodates bone grafting deep to the cage, relies on mechanical fixation alone
Customized triflange implant	Requires several weeks or month to obtain implant, serves as a good salvage option in cases of catastrophic bone loss and discontinuity, may achieve biologic fixation