Management of Contained Medial [Protrusiol] Acetabular Defects in Revision Total Hip Arthroplasty

Medial migration of the acetabular cup and protrusio of the medial wall is a well recognized failure mechanism of acetabular fixation in cemented total hip arthroplasty. In the protruded acetabulum, a medialized position of the acetabular component is associated with increased medial cortical bone stresses, while more lateral positioning reduces the medial stresses. Use of a protrusio ring or medial wire mesh may limit medial migration. However, late failure of acetabular revision reconstructions can occur when cemented protrusio rings or wire mesh reinforcement are used without bone grafting.