Salvage of acetabular insufficiency with bipolar prostheses

Salvage of severely compromised, deficient, and insufficient acetabula associated with failed total hip arthroplasty, nonunited or malunited acetabular fractures, and metastatic tumor can be accomplished with the bipolar prosthesis. The procedure must be regarded as a salvage procedure, providing the patient with limited functional capabilities. All patients are prescribed permanent external support, even though some have refused to use it. This procedure is usually done by means of a transtrochanteric approach and frequently requires bone grafting. The acetabular component is fitted as tightly as possible, consistent with complete seating, stability, and rim or equatorial fit, and, in my opinion, holds and molds the bone grafts. The procedure is far more acceptable and gives a much more functional result than a Girdlestone resection. If necessary, a standard total hip arthroplasty acetabular component could be inserted after graft incorporation, fracture healing, or both.