SummaryTotal hip arthroplasty after failed open reduction internal fixation of acetabular fractures can be challenging surgery. Recent studies reported that operative time, blood loss, and complication rates are higher than with primary total hip arthroplasty. Soft tissue scarring, heterotopic bone, fracture nonunion, and retained hardware contribute to this increased complexity of the reconstruction. Despite perioperative difficulties with total hip arthroplasty in this patient population, excellent outcome with modern cementless acetabular components can be expected.