Total Hip Arthroplasty Following Previous Acetabular Fracture

For patients with end-stage post-traumatic arthritis or osteonecrosis of the femoral head, conversion total hip arthroplasty (THA) can be an effective treatment option. It is more technically difficult than routine THA for inflammatory arthritis or osteoarthritis and it is associated with more complications. Preparation of the acetabulum is often the most technically challenging aspect of the operation. Newer technology is available to improve implant fixation. Surgical techniques will vary by acetabular defect type and size, and the use of bone graft is frequently required. Removal of previous hardware is not always required. Heterotopic ossification should be addressed with excision and appropriate prophylaxis instituted. A review of recent literature suggests that cementless fixation and improved implant design have improved the clinical outcome in these patients.