Acetabular revision using a trabecular metal acetabular component for severe acetabular bone loss associated with a pelvic discontinuity.
Pelvic discontinuity can be encountered during acetabular revision in patients with severe bone loss. All patients who had an acetabular reconstruction for a type IIIB acetabular defect according to the classification of Paprosky et al [Paprosky WG, Perona PG, Lawrence JM. 1994. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty 9:33.] with an associated pelvic discontinuity between 2001 and 2003 were reviewed. A trabecular metal acetabular component with or that without an acetabular augment was used to obtain fixation proximal and distal to the discontinuity. Thirteen patients (13 hips) were treated for a type IIIB acetabular defect. At an average of 2.6 years of follow-up, 1 patient demonstrated possible radiographic loosening. The other 12 patients maintained radiographically stable hips. None of the patients required repeat surgical intervention. Clinically, the patients' modified Postel-Merle d'Aubigne score improved from 6.1 preoperatively to 10.3 postoperatively. The treatment of pelvic discontinuity during acetabular revision using a trabecular metal acetabular component with or that without an associated trabecular metal augment appears to provide reliable and reproducible short-term results.
Sporer
Scott M
SM
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois; Central Dupage Hospital, Winfield, Illinois, USA.
Paprosky
Wayne G
WG
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000150:complications / Q000209:etiology*; D010384:Pelvic Bones / Q000473:pathology* / Q000601:surgery; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome