title: [Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach].
abstract: OBJECTIVE
  Reconstruction/stable fixation of the acetabular columns to create an adequate periacetabular requirement for the implantation of a revision cup.
  
  
  METHODS
  Displaced/nondisplaced fractures with involvement of the posterior column. Resulting instability of the cup in an adequate bone stock situation.
  
  
  METHODS
  Periprosthetic acetabulum fractures with inadequate bone stock. Extended periacetabular defects with loss of anchorage options. Isolated periprosthetic fractures of the anterior column. Septic loosening.
  
  
  METHODS
  Dorsal approach. Dislocation of hip. Mechanical testing of inlaying acetabular cup. With unstable cup situation explantation of the cup, fracture fixation of acetabulum with dorsal double plate osteosynthesis along the posterior column. Cup revision. Hip joint reposition.
  
  
  METHODS
  Early mobilization; partial weight bearing for 12 weeks. Thrombosis prophylaxis. Clinical and radiological follow-ups.
  
  
  RESULTS
  Periprosthetic acetabular fracture in 17 patients with 9 fractures after primary total hip replacement (THR), 8 after revision THR. Fractures: 12 due to trauma, 5 spontaneously; 7 anterior column fractures, 5 transverse fractures, 4 posterior column fractures, 1 two column fracture after hemiendoprosthesis. 5 type 1 fractures and 12 type 2 fractures. Operatively treated cases (10/17) received 3 reinforcement ring, 2 pedestal cup, 1 standard revision cup, cup-1 cage construct, 1 ventral plate osteosynthesis, 1 dorsal plate osteosynthesis, and 1 dorsal plate osteosynthesis plus cup revision (10-month Harris Hip Score 78 points). Radiological follow-up for 10 patients: consolidation of fractures without dislocation and a fixed acetabular cup. No revision surgeries during follow-up; 2 hip dislocations, 1 transient sciatic nerve palsy.
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin - Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Deutschland. philipp.schwabe@charite.de.
authors.forename: P
authors.initials: P
authors.lastname: Schwabe
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin - Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Märdian
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin - Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Perka
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin - Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: K-D
authors.initials: KD
authors.lastname: Schaser
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
keywords: Fracture fixation; Hip joint; Periprosthetic fracture; Plate osteosynthesis; Total hip replacement