As you know, in general, if prosthesis is not loose (and from the x-ray cup seems to be well fixed), we do not have to replace it.
1. Problem is that would be very hard to provide good stability - good job fixing the fracture with cup in place, although, of course,it is possible.
2. My preference would be to remove the cup. Having excellent view, approach to the acetabulum and good fixation can be accomplished (this has to be the premice, fracture well fixed before the cup in order to put in it); now, if you use the metal cup with multiple holes, it does work like nice plate and additional fixation to the fracture. If the cup is coated with hydroxy appatite, that will make healing and incorporation even better.
I hope this helps, sincerely
Enes M. Kanlic, MD, PhD
Associate Professor
Department of Orthopaedics
TTUHSC in El Paso, Texas
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