Unpressurised cement acetabular liner (UCAL)--an additional technique for enhancing hip spacer performance.

First stage revision of an infected hip can be a complex procedure. Effective infection control may dictate leaving a skeletalised hip with bony defects. Decisions must be made to adapt to the intra-operative findings. It is important that the surgeon has many options to deal with the many potential challenges. The ideal spacer preserves the remaining bone stock but also allows articulation, is stable in doing so, delivers antibiotics locally, is resistant to breakage and is easily removed. Current spacer options struggle to achieve all of these goals. The use of an unpressurised cement acetabular liner (UCAL) is an additional option, which bestows a number of advantages. We describe two cases, which illustrate this.