Grading acetabular defects: the need for a universal and valid system.
Preoperative classification of acetabular bone loss in revision total hip arthroplasty has been problematic. An evidence-based approach involves having a validated and widely accepted system of classification. A prerequisite would be a system that describes each defect in terms that are mutually exclusive, hierarchical, surgically relevant, and corresponding to experienced clinicians' preoperative estimates of surgical complexity. Of the 6 systems reviewed, only 1 demonstrated the reliability and validity required for a standardized grading system. Although high-grade defects were seen in only 17% of the 1094 hips, the failure rate associated with them was 30%. A larger population of high grade defects is necessary to determine which treatment alternatives are successful.
Department of Orthopaedic Surgery, Hahnemann University Hospital, Philadelphia, Pennsylvania 19102, USA.
Norman A
NA
Johanson
Kim R
KR
Driftmier
Douglas L
DL
Cerynik
Charles C
CC
Stehman
D000077:Acetabulum / Q000473:pathology* / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip; D001862:Bone Resorption / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D011475:Prosthesis Failure; D012086:Reoperation; D015203:Reproducibility of Results