State-of-the-art on reconstruction of massive acetabular defects in revision total hip arthroplasty: a commentary on “Comparable results with porous metal augments in combination with either cemented or uncemented cups in revision hip arthroplasty: an analysis of one hundred forty seven revisions at a mean of five years”

Complex acetabular bone defects are challenging even for the most experienced hip reconstructive surgeons. Paprosky type IIIA and IIIB defects, which present both peripheral and cavitary deficiencies, can be managed with numerous options: high placement of porous-coated acetabular component; Burch-Schneider anti-protrusio cages; customized triflange cups; standard-size cemented or uncemented cups along with either bulk structural allograft, impaction grafting over a metal mesh, or metal augments and, more recently, tantalum trabecular-metal cups, frequently used as jumbo cups at our institution (with or without metal-porous augments).