Massive acetabular bone loss with pelvic discontinuity remains a challenging obstacle with few arthroplasty solutions. We present a case of a 61-year-old man with multiple myeloma who suffered a pathologic acetabular fracture resulting in acetabular protrusio and eventually extensive acetabular bone loss. His prognosis was initially poor; however, he ultimately responded to his radiation and chemotherapy and was limited in his mobility by his extensive acetabular bone loss. Given his complex presentation, it was decided to go forward with total hip arthroplasty utilizing the Zimmer-Biomet custom triflange acetabular component. His outcome at 9 months is fair

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