Acetabular reconstruction using a Kerboull-Tanaka reinforcement device

Background: Acetabular bone loss presents a significant challenge in revision total hip arthroplasty, necessitating robust reconstruction techniques to ensure implant longevity. While the Kerboull cross-plate and structural allografts provide effective stabilization, anatomical restoration can be technically demanding, particularly when limb length management or limited graft availability complicates the procedure.

Objective: This article describes the design, indications, and surgical application of the Kerboull-Tanaka (KT) reinforcement device, a modified titanium cross-plate developed to address complex acetabular defects and facilitate adjustable hip center positioning.

Key Points: The KT device features a distal hook for inferior rim fixation and a proximal plate for iliac screw stabilization. It is available in three models allowing for anatomical placement or superior displacement of the center of rotation by 10 mm or 15 mm. This flexibility assists in managing limb length discrepancies and reducing graft volume requirements in cases of high-riding stable stems or pelvic obliquity. Surgical success relies on precise preoperative 3D planning and the use of structural allografts, autografts, or hydroxyapatite granules to restore cavitary and segmental deficits. Clinical data indicate a 10-year survival rate of 94.8% for AAOS type III defects. The device provides mechanical support that reduces stress on structural grafts, preventing collapse in massive bone loss and pelvic discontinuity.

Conclusion: The KT reinforcement device combined with structural allografting is a reliable method for managing severe acetabular bone loss. It offers a versatile alternative to cementless jumbo cups or trabecular metal augments by restoring bone stock and allowing controlled hip center elevation.