Revision of total hip arthroplasty for aseptic loosening: the acetabulum

Very predictable results can be obtained from revision of the aseptically loose acetabular prosthesis by using cement fixation if: the hip is taken apart completely so that complete access to the acetabulum is obtained, a bed of bone of adequate strength completely devoid of soft tissue is prepared, a new prosthesis, backed with a metal shell, is selected to distribute the applied load as evenly as possible and thus minimize peak stresses in cement or bone, and this prosthesis is inserted as far medially, inferiorly, and anteriorly as possible to create a new anatomic geometry that, during function, will place as little load on the hip as possible.