Acetabular reconstruction by bonne graft and reinforcement ring

The treatment of acatabular bone loss during revision THA may involve different options. One of them consists of restoring the patient's anatomy by repositioning the center of rotation of the hip in its original position and filling the loss of bone by grafting bone tissue (most often allograft). This most often requires protecting the grafts during their osseointegration by using a reinforcement ring within which a PE or DM cup can be cemented. Several armature models are commonly used. They are fixed to the iliac bone by means of screws (Müller ring), with additional fixation by an obturator hook (Ganz ring, Kerboull cross) or an ischial tab (Burch-Schneider cage). These reinforcement devices exert a protective effect on the grafts used with stresses transmitted in the presence of a reinforcement equal to 35 to 47% of the stresses transmitted by a cup implanted without a reinforcement. Different studies tend to demonstrate that the results are independent of the type and structure (3) of the grafts used. On the other hand, each framework obtains variable results depending on the severity of the lesions treated. Other techniques using such ascup-cages or custom implants seem more suitable when there is major destruction with pelvic discontinuity