The surgical approach depends on the following points: 1) the surgical approach to the original acetabular fracture; 2) whether the internal fixation and heterotopic bone need to be removed; 3) whether there is a combination of sciatic nerve injury; 4) the familiarity of the surgeon with the approach, etc. The posterior-lateral approach is mostly used for this type of patients, which has achieved good results without complications such as loosening and sciatic nerve injury so far. If a posterior approach was previously used, attention should be paid to previous scar adhesions when choosing a postero-lateral approach to THA. The external rotator muscle group is cut along the inter-rotor line, and if there is no preoperative manifestation of sciatic nerve injury, the sciatic nerve is usually not revealed, but its integrity should be palpated and protected. The postero-lateral approach allows for greater exposure of the posterior aspect of the acetabulum and meets almost all the requirements for THA except for the occasional need to combine an anterior approach to aid in the removal of the anterior acetabular screws. If an anterior approach has been used for previous fracture fixation, care should be taken when using the postero-lateral approach to release the anterior acetabular rim, as the adherent scar tissue may cause anterior vascular damage, but incomplete release may result in difficult repositioning after prosthesis placement, which is particularly common in patients with femoral head dislocation. The acetabular prosthesis is primarily a biologic prosthesis, with bone cement prosthesis being used sparingly. In most cases, a normal biologic acetabular prosthesis is sufficient. A high friction acetabular prosthesis, such as the Zimmer metal trabecular prosthesis, is considered when the following conditions occur 1, acetabular bone defect; 2, displaced fracture block sclerosis or necrosis; 3, after correct reaming and filing of the acetabulum, some scar tissue still remains in the acetabulum, etc., which may affect the normal bone growth into. The current classification methods for acetabular bone defects are mainly AAOS classification, Paprosky classification and Gross classification. We believe that Gross classification is more applicable to the description of bone defects after acetabular fracture, and Gross classification classifies acetabular bone defects into type I inclusive bone defects and type II non-inclusive bone defects. Inclusive bone defects have an intact acetabular ring and can be operated with either a plain or a revision prosthesis (acetabular rim fixation) with the defect area filled with granulated bone. Non-inclusive bone defects are further divided into two subtypes, IIA and IIB. Type IIA is a defect of the acetabular roof or part of the acetabular column, but the missing area of the acetabular wall does not exceed 50% of the entire acetabular area. type IIB is a defect of one or both columns, and the missing area of the acetabular wall exceeds 50% of the acetabular area. The reason for the 50% threshold is that the initial stability of the acetabular prosthesis relies on the clamping effect of the acetabular ring, and when the residual acetabular ring exceeds 50%, it is able to provide effective clamping of the acetabular prosthesis without the need for auxiliary support. Conversely, when the acetabular ring is unable to provide effective clamping of the acetabular prosthesis, adjunctive support, such as the use of large structural bone grafts or metal reinforcement blocks, or even reinforcement rings, has to be implemented.