Management of periacetabular bone loss in revision hip arthroplasty.
The goals of acetabular revision surgery are to restore the anatomy and achieve stable fixation for the new acetabular component. The existing bone stock and the type of defect are determining factors in the surgical decision making. When necessary, and especially in younger patients, attempts should be made to restore the bone stock by grafting. The advent of modern reconstruction options, like the trabecular metal revision system and the cup-cage construct, provide more options in addressing the management of severe defects. Trabecular metal has a porosity similar to bone and provides an environment more favorable to bone graft remodeling than conventional metals. We present an overview of our experience and current approach to acetabular revision. In addition, we report our preliminary results with trabecular metal cups and trabecular metal cup-cage constructs used in conjunction with bone graft for addressing major bone defects.
Boscainos
Petros J
PJ
Division of Orthopaedic Surgery, Toronto East General Hospital, Toronto, ON, Canada.
Kellett
Catherine F
CF
Maury
Anthony C
AC
Backstein
David
D
Gross
Allan E
AE
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D011474:Prosthesis Design; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking