D'Antonio et al classified defects in the acetabulum that may be encountered when performing a total hip arthroplasty.
Acetabular Defect
Type
segmental deficiency (complete loss of bone in the supporting hemisphere of the acetabulum)
I
cavitary deficiency (volumetric loss of bony substance of the cavity but the acetabular rim is intact)
II
combined segmental and cavitary deficiencies
III
pelvic discontinuity
IV
arthrodesis
V
where:
• Pelvic discontinuity occurs when there is a defect affecting the anterior and posterior columns of the acetabulum, with a total separation of the superior and inferior portions of the acetabulum.
• Arthrodesis refers to surgical fusion/fixation with the entire bony cavity filled with bone. This poses a technical difficulty since the location of the true acetabulum may be a problem.
A peripheral deficiency in a segment or cavity may be:
(1) superior
(2) anterior
(3) posterior
A central deficiency in a segment or cavity refers to the medial wall.
(1) A segmental defect in the central segment implies that the medial wall is absent.
(2) A cavitary defect in the central segment implies that the medial wall is intact.
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