Reconstruction With Rib Graft for Acetabular Revision in Pelvic Discontinuity: An Extreme Solution?

Acetabular osteolysis associated with socket loosening is one of the main long-term complications of total hip arthroplasty. In case of major bone loss, even metal ring or cage in association showed poor long-term outcome. To promote allograft bone consolidation and acetabular stability, we have associated a rib graft and column fixation to reconstruct the acetabular surface. Here, we describe 8 cases and the technical details of major acetabular reconstruction using revision cup with autologous rib graft. The main advantages of this procedure are the aid in allograft integration and partial unload of the allograft. Our preliminary results using rib bone graft indicate a good allograft consolidation and remodeling. The small number of patients does not allow conclusions about the efficacy of this technique but it offers another solution for extreme severe bone loss.