title: Pelvic discontinuity: current solutions.
abstract: Pelvic discontinuity represents a rare but challenging problem for orthopaedic surgeons. It is most commonly encountered during revision total hip replacement, but can also result from an iatrogentic acetabular fracture during hip replacement. The general principles in management of pelvic discontinuity include restoration of the continuity between the ilium and the ischium, typically with some form of plating. Bone grafting is frequently required to restore pelvic bone stock. The acetabular component is then impacted, typically using an uncemented, trabecular metal component. Fixation with multiple supplemental screws is performed. For larger defects, a so-called 'cup-cage' reconstruction, or a custom triflange implant may be required. Pre-operative CT scanning can greatly assist in planning and evaluating the remaining bone stock available for bony ingrowth. Generally, good results have been reported for constructs that restore stability to the pelvis and allow some form of biologic ingrowth.
authors.affiliation: Orlando Health Orthopedic Insitute, 1222 S. Orange Ave, Orlando, Florida 32806, USA.
authors.forename: J
authors.initials: J
authors.lastname: Petrie
authors.forename: A
authors.initials: A
authors.lastname: Sassoon
authors.forename: G J
authors.initials: GJ
authors.lastname: Haidukewych
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D006620:Hip Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D007049:Iatrogenic Disease; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D057068:Periprosthetic Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000517:prevention & control; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D014057:Tomography, X-Ray Computed
keywords: Pelvic discontinuity; revision total hip arthroplasty; Iatrogenic pelvic discontinuity; acetabular fracture