RT Journal
A1 Sporer, Scott M.
T1 How to Do a Revision Total Hip Arthroplasty: Revision of the Acetabulum
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD July 20
VO 93
IS 14
SP 1359
OP 1366
DO 10.2106/JBJS.9314icl
UL http://dx.doi.org/10.2106/JBJS.9314icl
AB 
The most common indications for acetabular revision include instability, infection, polyethylene wear, and aseptic loosening1. The prevalence of these conditions remains essentially unchanged despite improved prosthetic component designs and enhanced surgical techniques. A successful acetabular revision must provide intimate contact between the acetabular implant and the host bone, a stable mechanical construct minimizing micromotion to allow bone ingrowth into a cementless acetabular component, and a mechanical construct that distributes the physiologic stresses to the surrounding acetabular bone. Additionally, the acetabular reconstruction must allow appropriate component orientation to minimize the risk of dislocation and reestablish the anatomic hip center to improve the overall joint kinematics. Biologic methods of acetabular reconstruction are advised except in cases of severe bone loss or prior radiation treatment in the hip region, since nonbiologic revisions eventually fail2. Periacetabular bone loss can compromise component fixation, resulting in early loosening of the revised acetabulum. The amount of bone loss undoubtedly influences the ability to obtain initial optimal fixation. The location of remaining supportive bone, however, has a more important role in providing durable fixation than does the quantity of bone loss.