Older man with hip dislocation, fracture of femoral head and posterior wall

Repeat radiographic evaluation prior to the patient's definitive surgery again demonstrated a chronic left posterior wall fracture with associated femoral head fracture/dislocation with signs of progressive femoral head collapse and posterior wall resorption (Figure 2). Wayne G. Paprosky, MD, FACS, and colleagues, classified acetabular defects based on the location of bone loss affecting the teardrop, ischium and direction of component migration in conjunction with the ability to provide rigid support for an acetabular component. Based on the degree of support, Paprosky and colleagues proposed the type and amount of graft required to mitigate instability. Since these guidelines were introduced by Paprosky, both cemented and noncemented techniques have been described. While porous-coated hemispherical cups with screws have been successfully used in scenarios that involve upward of 50% contact loss, acetabular augments can be effectively used in unique scenarios.