Retroacetabular Osteolysis

Retroacetabular osteolysis is a significant problem in total hip arthroplasty. Clinical,  radiographic, and histologic data have linked particulate debris from component wear to  progressive bone loss, loosening, and eventual failure of the implant.1-3 Not only does this  osteolysis result in eventual failure of the implant, but also it provides considerable technical  difficulty during revision surgery. Obtaining a stable platform for the revision acetabular  component is dependent on the quality of the remaining bone and the location and the severity of the bone loss. Many classification systems have been proposed for characterizing  acetabular bone loss.4 These include those proposed by Chandler and Penenberg,5 Paproski  and associates,6,7 Engh and Glassmann,8,9 and D’Antonio and associates.10 The classification  system of D’Antonio and associates has been recommended by the American Academy of Orthopedic Surgeons (AAOS) and is shown in the Table.