Revision Total Hip Arthroplasty for Pelvic Discontinuity

DeBoer, David K.; Christie, Michael J.; Brinson, Martha F.; Morrison, Joan

doi:10.2106/00004623-200704000-00020

Cited by 93 publications

(41 citation statements)

References 8 publications

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“…Other studies using custom-made acetabular implants for large defects in revision THA did not study the INCL, AV, rotation and restoration of the COR of the implant. [22][23][24][25][26] There are few reports about differences in the COR. Measurements of the COR are often performed in different planes on conventional radiographs.…”

Section: Discussionmentioning

confidence: 99%

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The accuracy of positioning of a custom-made implant within a large acetabular defect at revision arthroplasty of the hip

Baauw

et al. 2015

The Bone & Joint Journal

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We evaluated the accuracy with which a custom-made acetabular component could be positioned at revision arthroplasty of the hip in patients with a Paprosky type 3 acetabular defect. A total of 16 patients with a Paprosky type 3 defect underwent revision surgery using a custom-made trabecular titanium implant. There were four men and 12 women with a median age of 67 years (48 to 79). The planned inclination (INCL), anteversion (AV), rotation and centre of rotation (COR) of the implant were compared with the post-operative position using CT scans. A total of seven implants were malpositioned in one or more parameters: one with respect to INCL, three with respect to AV, four with respect to rotation and five with respect to the COR. To the best of our knowledge, this is the first study in which CT data acquired for the pre-operative planning of a custom-made revision acetabular implant have been compared with CT data on the post-operative position. The results are encouraging.

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Section: Discussionmentioning

confidence: 99%

“…There were few complications compared with most studies which address custom-made acetabular implants. [22][23][24][25][26] One of the two dislocations can probably be explained because it was malpositioned. The other implant that dislocated, however, was perfectly positioned.…”

Section: Discussionmentioning

confidence: 99%

The accuracy of positioning of a custom-made implant within a large acetabular defect at revision arthroplasty of the hip

Baauw

et al. 2015

The Bone & Joint Journal

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“…Bone loss may be due to infection, osteolysis or mechanical abrasion ( Figure 12). 17 Pelvic discontinuity is more common in women and patients with rheumatoid arthritis. Pelvis radiotherapy is also a risk factor.…”

Section: Fractures and Pelvic Discontinuitymentioning

confidence: 99%

“…Pelvic discontinuity may require reconstruction with a plate and anti-protrusio acetabular cage before insertion of bulk allograft and a cemented cup or a custom built acetabular component. 17,19 Metal-on-metal soft tissue reaction Technical advances with improvements in machine tolerances have result in the development of second and third generation metal on metal prostheses. These prostheses have the potential advantage of avoiding the problems of small particle disease and osteolysis which are recognized complications associated with conventional metal on polyethylene prostheses.…”

Section: Fractures and Pelvic Discontinuitymentioning

confidence: 99%

(iii) CT and MRI of hip replacements

Cahir¹,

Toms²

2009

Orthopaedics and Trauma

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“…1,[11][12][13][14][15][16][17][18] The best choice of technique is dependent upon the nature of the discontinuity, the amount of available bone stock, and the likelihood of achieving stable healing between the two segments. Here we describe a method of treating pelvic discontinuity using porous tantalum components associated with a distraction technique that achieves both initial stability and subsequent long-term biological fixation.…”

mentioning

confidence: 99%

Acetabular distraction

Brown

Hellman

Haughom

et al. 2014

The Bone & Joint Journal

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A pelvic discontinuity occurs when the superior and inferior parts of the hemi-pelvis are no longer connected, which is difficult to manage when associated with a failed total hip replacement. Chronic pelvic discontinuity is found in 0.9% to 2.1% of hip revision cases with risk factors including severe pelvic bone loss, female gender, prior pelvic radiation and rheumatoid arthritis. Common treatment options include: pelvic plating with allograft, cage reconstruction, custom triflange implants, and porous tantalum implants with modular augments. The optimal technique is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable healing between the two segments. A method of treating pelvic discontinuity using porous tantalum components with a distraction technique that achieves both initial stability and subsequent long-term biological fixation is described.

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Revision Total Hip Arthroplasty for Pelvic Discontinuity

Cited by 93 publications

References 8 publications

The accuracy of positioning of a custom-made implant within a large acetabular defect at revision arthroplasty of the hip

The accuracy of positioning of a custom-made implant within a large acetabular defect at revision arthroplasty of the hip

(iii) CT and MRI of hip replacements

Acetabular distraction

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