Conversion total hip replacement with hardware removal after open reduction and internal fixation of the acetabulum: insights from two case reports

Abstract This case report describes two 49-year-old patients who developed post-traumatic osteoarthritis following open reduction and internal fixation (ORIF) of right acetabular fractures, necessitating hardware removal and conversion to total hip arthroplasty (THA). Using anterior approaches for ORIF and hardware removal, followed by a direct lateral approach for THA, both patients achieved significant functional improvement without complications at the 2-year follow-up. These cases highlight the challenges in managing acetabular fractures in younger patients, emphasizing the importance of tailored surgical strategies to delay THA, address bone defects, and optimize outcomes.