Acetabular bone loss in primary and revision arthroplasty: diagnosis, imaging, classification and management

TY - JOUR

T1 - Acetabular bone loss in primary and revision arthroplasty

T2 - diagnosis, imaging, classification and management

AU - Metheringham, Samuel

AU - MacKenzie, Samuel

AU - Sargeant, Harry

N1 - Publisher Copyright: © 2025 .

PY - 2025/12/26

Y1 - 2025/12/26

N2 - The number of total hip arthroplasties being performed every year is increasing. With the average age of these patients decreasing, combined with average life expectancy increasing, the future revision hip workload is set to increase. A rare but important factor associated with implant failure and subsequent revision surgery is acetabular bone loss. Bony defects of the acetabulum can pose a challenge in diagnosis, imaging, classification and management. In this review, we discuss the relevant anatomy of the hip and pelvis, the preoperative work-up and imaging patients undergo, the various classification systems that exist and how those systems guide management. Treatment options include hemispherical acetabular cups, cup-cage constructs, reconstructive rings and cages, bone impaction grafting allografts, metal augments and patient specific implants.

AB - The number of total hip arthroplasties being performed every year is increasing. With the average age of these patients decreasing, combined with average life expectancy increasing, the future revision hip workload is set to increase. A rare but important factor associated with implant failure and subsequent revision surgery is acetabular bone loss. Bony defects of the acetabulum can pose a challenge in diagnosis, imaging, classification and management. In this review, we discuss the relevant anatomy of the hip and pelvis, the preoperative work-up and imaging patients undergo, the various classification systems that exist and how those systems guide management. Treatment options include hemispherical acetabular cups, cup-cage constructs, reconstructive rings and cages, bone impaction grafting allografts, metal augments and patient specific implants.

KW - Acetabulum

KW - applied surgical anatomy

KW - hip replacement

KW - imaging of the acetabulum

KW - Paprosky classification

KW - pelvic discontinuity

UR - https://www.scopus.com/pages/publications/105026786274

U2 - 10.1016/j.mporth.2025.11.006

DO - 10.1016/j.mporth.2025.11.006

M3 - Article

AN - SCOPUS:105026786274

SN - 1877-1327

JO - Orthopaedics and Trauma

JF - Orthopaedics and Trauma

ER -