Fig. 1

Serial anteroposterior radiographs of the patient who underwent four revision surgeries of the right hip joint. a Radiograph at age 39, showing dysplastic hip joint osteoarthritis; b after primary total hip arthroplasty (THA) at 40 years; c 11 years after the primary THA, showing loosening of both femoral stem and acetabular cup; d immediately after the first revision THA at age 51; e 10 years after the first revised surgery, showing acetabular cup loosening; f after the second revision surgery. The acetabular component was reconstructed with Kerboull reinforcement plate; g 3 years after the second revision surgery, showing breakage of the reinforcement plate and resorption of the graft bone; h after the third revision surgery using Müller ring with impaction bone grafting; i 3 years after the final revision at age of 72; j 7 years after the final revision surgery with stabilization of the two acetabular columns. Note healing of the pelvic discontinuity lesion