Treatment of Severe Acetabular Deficiency Using Modular Trabecular Metal Components

Acetabular fixation in patients requiring revision total hip arthroplasty who have a nonsupportive superior dome and proximal migration of the acetabular component (Paprosky type IIIA defect) or who have a nonsupportive anterior and posterior column with proximal/medial migration of the acetabular component (Paprosky type IIIB defect) cannot be achieved reliably with the use of a hemispherical porous-coated component alone. Pelvic discontinuity is frequently encountered in patients with severe acetabular bone loss. Treatment of the discontinuity is dependent upon the remaining host bone, potential for healing of the discontinuity, and potential for biologic ingrowth of acetabular components. If healing potential for the discontinuity does not exist, the discontinuity should be bridged and treated with distraction using trabecular metal components with augments.