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The primary outcome included Harris Hip Score at 6 months, Secondary outcomes included postoperative complications, unplanned reoperation, and radiographic implant assessment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At six months, both replacement groups showed significantly better functional outcomes (mean Harris hip scores of 83 and 82) compared to the fixation-only group (mean score of 57;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). All reoperations (4\/20) occurred in the fixation group, while no reoperation was required in the replacement groups. Radiographic evaluation confirmed stable implant fixation in all arthroplasty cases, without signs of loosening or dislocation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>According to our treatment algorithm, acute total hip replacement using a modular revision cup with an iliac peg, with or without plate osteosynthesis, offers the advantage of early full weight-bearing and promising functional outcomes in the management of complex acetabular fractures. These results support the integration of acute total hip replacement into structured decision-making protocols especially for elderly patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-025-03045-9","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:05:32Z","timestamp":1766052332000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute total hip replacement of acetabular fractures with cementless modular revision cups in patients older than 55 years: a retrospective cohort study"],"prefix":"10.1007","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6259-7985","authenticated-orcid":false,"given":"Mohammed","family":"Rashed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hildebrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Hofmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Horst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"H\u00fcrtgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eftychios","family":"Bolierakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Berk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatem","family":"Alabdulrahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"3045_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijotn.2023.101049","volume":"53","author":"AA Khalifa","year":"2024","unstructured":"Khalifa AA, Mahran DG, Fergany A, Farouk O. 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