Acetabular reconstruction in revision total hip arthroplasty: maximizing function and outcomes in protrusio and cavitary defects.
Osteolysis in the periacetabular region is a common long-term complication of total hip arthroplasty that can lead to bone loss, implant loosening, and protrusio. Several systems have been developed for classifying osteolysis and guiding treatment. Options such as bone grafting or augmentation, with exchange of the bearing surface and, in some cases, revision of the acetabular component, can be used for treatment. Most cavitary and protrusio defects can be treated with a cementless revision cup using screw fixation and grafting with morcellized bone. However, structural augmentation, custom components, or cage reconstruction may occasionally be necessary for managing larger defects with severe loss of acetabular bone stock.
Resident, Department of Orthopaedic Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.
Brian
B
Dahl
Christian
C
McNeely
Brooke S
BS
Robinson
William J
WJ
Maloney
Wayne G
WG
Paprosky
Michael D
MD
Ries
Khaled J
KJ
Saleh
D000077:Acetabulum; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016025:Bone Transplantation; D006622:Hip Prosthesis; D006801:Humans; D010014:Osteolysis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000009:adverse effects; D020127:Recovery of Function; D012086:Reoperation; D016896:Treatment Outcome