Abstract
Acetabular fractures can complicate hip arthroplasty and result in higher rates of intraoperative complications and worse long-term outcomes1. Previous studies have shown increased rates of acetabular-sided complications and worse long-term outcomes in the setting of prior acetabular fractures. We present a total hip arthroplasty complicated by severe post-traumatic arthritis and a vascular necrosis. The patient was found to have a Paprosky Type IIA acetabular defect with exposed intra-articular hardware due to a previous both-column acetabulum fracture treated with open reduction and internal fixation. Cancellous autograft was used for acetabular reconstruction and a cementless acetabular cup was inserted, as survival has been shown to be superior to cemented cups in patients with acetabular deficiency. Subsequent follow-up showed well fixated components with a good functional outcome in this patient.