Authors of section

Authors

Derek Donegan, Michael Huo, Michael Leslie

Executive editor

Michael Baumgaertner

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Acetabular cup removal

1. Cup screw removal

The surgeon must ensure that all the cup screws were removed prior to attempting to remove the cup itself.

Screw removal for acetabular cup removal

If acetabular component is secured with screws, remove the polyethylene portion to expose the screws.

There are two commonly used techniques for bearing removal:

  • Use of an osteotome at the liner-shell junction to lever and to remove the liner
Polyethylene component removal from an acetabular cup
  • Use a threaded extraction tool or cancellous screw to push out the liner

In the event neither technique is successful, the liner should be sectioned with a high-speed burr in order to access the screws. Forceful extraction of the cup with the screws in place will result in major disruption of the acetabulum and substantial neurovascular injury.

Polyethylene component removal from an acetabular cup

Remove the screws and the cup with available equipment.

Screw removal from an acetabular cup

In the rare case in which the screw head is stripped, or broken, the surgeon can consider using a high-speed burr to loosen or to remove the screw head in order to remove the cup.

Screw head removal with a high-speed burr

2. Option 1: hand-held tools for cup removal

Cup removal can be performed using hand-held tools.

Hand-held tools for cup removal

Choose the osteotome that most closely matches the outer diameter of the cup.

Acetabular cup removal with an osteotome

3. Option 2: acetabular osteotome system for cup removal

Another well validated technique for cup removal is using an acetabular osteotome system.

Acetabular osteotome system for cup removal

To free the peripheral bone-cup interface, start with the shorter blade that most closely matches the outer diameter of the cup.

Acetabular osteotome system for cup removal with short blade

Longer blade(s) is used to free up the bone-cup interface closer to the dome.

Acetabular osteotome system for cup removal with long blade

Remove the cup once it is loose.

Acetabular cup removal