Acetabular distraction: an alternative approach to pelvic discontinuity in failed total hip replacement.
A pelvic discontinuity occurs when the superior and inferior parts of the hemi-pelvis are no longer connected, which is difficult to manage when associated with a failed total hip replacement. Chronic pelvic discontinuity is found in 0.9% to 2.1% of hip revision cases with risk factors including severe pelvic bone loss, female gender, prior pelvic radiation and rheumatoid arthritis. Common treatment options include: pelvic plating with allograft, cage reconstruction, custom triflange implants, and porous tantalum implants with modular augments. The optimal technique is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable healing between the two segments. A method of treating pelvic discontinuity using porous tantalum components with a distraction technique that achieves both initial stability and subsequent long-term biological fixation is described.
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
N M
NM
Brown
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
M
M
Hellman
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
B H
BH
Haughom
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
R P
RP
Shah
Cadence Health, 25 N. Winfield Road, Winfield, Illinois, 60190, USA.
S M
SM
Sporer
Cadence Health, 25 N. Winfield Road, Winfield, Illinois, 60190, USA.
W G
WG
Paprosky
D000077:Acetabulum / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001862:Bone Resorption / Q000209:etiology / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D010384:Pelvic Bones / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation
total hip arthroplasty; revision total hip arthroplasty; pelvic distraction; acetabular bone loss; pelvic discontinuity