title: Severe pelvic bone loss treated using a coned acetabular prosthesis with a stem extension inside the ilium.
abstract: We describe a modified surgical technique for the reconstruction of major acetabular defects using a coned acetabular component (the Stanmore 'ice-cream' cone prosthesis) and report its early clinical outcomes. A single surgeon performed 28 acetabular reconstructions using a stemmed-cone acetabular prosthesis (mean age 70.9 years; 61% female) in 15 oncology patients with periacetabular metastases and 13 patients requiring complex arthroplasty procedures. Defects were graded using the Paprosky classification (10 = 3A; 8 = 3B; 10 = pelvic discontinuity). All procedures were performed without fluoroscopy using an extended posterior hip approach. Mean operative time (including anaesthesia) was 133 minutes; there were no intraoperative complications. Postoperative complications had occurred in 14% (n = 4), at a mean follow-up of 12.5 months (range: 2-33 months). There were no failures in patients with pelvic discontinuity. The stemmed-cone acetabular prosthesis was found to provide a useful method for acetabular reconstruction (including pelvic discontinuity) in both complex oncological and hip arthroplasty cases.
authors.affiliation: Royal Orthopaedic Hospital, Birmingham, United Kingdom. gsm@doctors.org.uk
authors.forename: Gulraj S
authors.initials: GS
authors.lastname: Matharu
authors.affiliation: Royal Orthopaedic Hospital, Birmingham, United Kingdom.
authors.forename: Roshana
authors.initials: R
authors.lastname: Mehdian
authors.affiliation: Royal Orthopaedic Hospital, Birmingham, United Kingdom.
authors.forename: Deepu
authors.initials: D
authors.lastname: Sethi
authors.affiliation: Royal Orthopaedic Hospital, Birmingham, United Kingdom.
authors.forename: Lee
authors.initials: L
authors.lastname: Jeys
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000473:pathology*; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure