Total hip replacement combined with acetabuloplasty was performed in 43 hips in 40 patients with protrusion secondary to arthrosis, rheumatoid arthritis or trauma. Depending on the acetabular defect, the acetabuloplasty encompassed reinforcement of the medial wall with bone grafts, vitallium meshes, protrusio rings and cups. The clinical and radiographic results were uniformly good on average 2 years postoperatively. All grafts appeared to be united and incorporated, without evidence of resorption. The only patient suffering from pain had radiographic signs of progressive varus migration of the femoral component.