Authors of section


Derek Donegan, Michael Huo, Michael Leslie

Executive editor

Michael Baumgaertner

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Intraoperative acetabular fracture during insertion with unstable component

General considerations

Intraoperative fractures that occurred during the insertion of a cup, with an unstable component, are classified as IB type fractures by Della Valle.

Type IB fractures have a stable or unstable pattern with loss of cup stability.

Della Valle I acetabular fracture occur intraoperatively during hip arthroplasty.

Further information about Della Valle classification can be found in the publication: Della Valle CJ, Momberger NG, Paprosky WG. Periprosthetic fractures of the acetabulum associated with a total hip arthroplasty. Instr Course Lect. 2003;52:281–290.

Della Valle IB acetabular fracture


  • Excessive or eccentric reaming leading to reduction of bone strength
  • Mismatch of cup size to the reaming preparation
  • Eccentric cup insertion leading to stress of the walls/columns

Clinical signs

  • Visible fracture line
  • Unstable cup by press-fit technique


  • Visual inspection and recognition are generally sufficient
  • Fluoroscopy or regular radiographs may further define the extent of the fracture patterns
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