Acute periprosthetic fracture of the acetabulum associated with osteolytic pelvic lesions

Three cases of acute acetabular fracture around uncemented porous-coated acetabular components associated with osteolytic lesions of the pelvis are reported. In each case, the fracture occurred through an area of severe osteolysis that contributed to the structural failure of the pelvis. None of the fractures were associated with significant trauma, and none of the implants demonstrated evidence of loosening before the fracture. When marked pelvic osteolysis develops around the acetabular component of a total hip arthroplasty, the possibility of pelvic fracture must be considered. Total hip arthroplasty patients with osteolysis should be followed with radiographs at regular and frequent intervals. When osteolysis progresses, early intervention should be strongly considered because appropriate treatment may prevent fracture occurrence.