Acetabular Cup Revision With the Use of the Medial Protrusio Technique at an Average Follow-up of 6.6 Years

Fabi, David; Gonzalez, Mark H.; Goldstein, Wayne M.; Ahmed, Muhammad Hammad

doi:10.1016/j.arth.2009.01.019

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…To preserve the anterior wall, other techniques such as higher placement of a smaller cup or use of a superior augment above an anatomically positioned cup can be used. Reaming medially through the medial wall to gain better superior coverage has also been used successfully as an alternative to a superior augment or bone graft [6,7,9]. The final decision of which technique to use is made intraoperatively based on a direct assessment of the remaining bone and acetabular anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…When reaming the acetabulum with these defects into a hemispherical shape, the large diameter required to span the distance from the superior defect to the inferior acetabulum results in an equal AP reaming dimension. Reaming through the medial wall and placement of a cup medial to Kohler's line to gain better superior coverage has been advocated in the treatment of hip dysplasia and revision THA without adverse consequences [6,7,9]. However, reaming through the anterior wall should be avoided because this can result in impingement between the anterior cup edge and iliopsoas tendon [5,14].…”

Section: Introductionmentioning

confidence: 99%

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Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Computer Simulation

Nwankwo

Dong

Heffernan

et al. 2013

Clin Orthop Relat Res

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Our results indicate that the jumbo cup technique results in hip center elevation despite placement of the cup adjacent to the inferior acetabulum. For a hypothetical increase from a 54-mm socket to a 72-mm socket, as one might see in the context of the revision of a failed THA, our model would predict an elevation of the hip center of approximately 5 mm and loss of approximately 15 mm of anterior column bone. This suggests that an increase in femoral head length may be needed to compensate for the hip center elevation caused by the use of a large jumbo cup in revision THA. A jumbo cup may also result in protrusion through the anterior wall.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Computer Simulation

Nwankwo

Dong

Heffernan

et al. 2013

Clin Orthop Relat Res

View full text Add to dashboard Cite

show abstract

“…Sequentially increasing reamer sizes are used until a reamer engages the superior host bone. Reaming also may be directed medially through the medial wall to gain better superior coverage [3,5]. However, with increasing reamer diameters to span the superior-to-inferior dimension of the acetabular bone defect, the anterior and/or posterior walls could be reamed away.…”

Section: Methodsmentioning

confidence: 99%

Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Radiographic Evaluation

Nwankwo

Ries

2014

Clinical Orthopaedics &Amp; Related Research

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“…The major complications associated with overreaming are intrapelvic vessel complications, urogenital tract complications, nervous system complications, and intrapelvic mass formation. The external iliac artery and vein, internal iliac artery and vein, obturator vessels and nerve, ureter, deferent duct, and the superior umbilical artery are the structure in close proximity to the medial wall which are at risk structures [9] . McQueary and Johnston [10] recommended medialization of the femoral head approximately 25 mm.…”

Section: Discussionmentioning

confidence: 99%

Uncemented acetabular component placement in developmental dysplasia of the hip (DDH) – time tested method revisited-medial protrusio technique

Jagannath¹,

Kumar²,

Karthik³

et al. 2021

Int. J. Orthop. Sci.

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Introduction: Proper positioning of the acetabular cup is pivotal in any total hip arthroplasty. Cases of DDH have shallow acetabulum which is deformed and oblong and the femur head corresponds to it. Identifying the correct centre of hip rotation is difficult. In this study we highlight the easy technique of "Medial protrusion technique" for cup placement. Materials and Methods: Skeletally mature patients with developmental dysplasia of hip showing clinical and radiological hip arthritis were included. Total of ten hips with DDH and hip arthritis underwent THA using this technique. Radiological evaluation with X ray and CT was done and the Harris hip score was calculated preoperatively and subsequently in all follow ups. Results: The average follow up period was 5.5 ± 1.3 years. The mean Harris hip score in these patients was 86.5 ± 1.4. Two patients out of 10 patients had excellent results, while 8 patients were rated as having good results. The average pain score was 41.6. The x-rays demonstrated good overall alignment and fixation of the acetabular cup. All cups were integrated well. Conclusion:Our study confirms that this technique is simple safe and easily reproducible and time reliable technique providing superior outcomes in uncemented THA in DDH cases.

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Acetabular Cup Revision With the Use of the Medial Protrusio Technique at an Average Follow-up of 6.6 Years

Cited by 10 publications

References 18 publications

Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Computer Simulation

Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Computer Simulation

Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Radiographic Evaluation

Uncemented acetabular component placement in developmental dysplasia of the hip (DDH) – time tested method revisited-medial protrusio technique

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