title: Pelvic Discontinuity Associated With Total Hip Arthroplasty: Evaluation and Management.
abstract: Pelvic discontinuity is a challenging complication encountered during revision total hip arthroplasty. Pelvic discontinuity is defined as a separation of the ilium superiorly from the ischiopubic segment inferiorly and is typically a chronic condition in failed total hip arthroplasties in the setting of bone loss. After a history and a physical examination have been completed and infection has been ruled out, appropriate imaging must be obtained, including plain hip radiographs, oblique Judet radiographs, and often a CT scan. The main management options are a hemispheric acetabular component with posterior column plating, a cup-cage construct, pelvic distraction, and a custom triflange construct. The techniques have unique pros and cons, but the goals are to obtain stable and durable acetabular component fixation and a healed or unitized pelvis while minimizing complications.
authors.affiliation: From the Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Abdel
authors.forename: Robert T
authors.initials: RT
authors.lastname: Trousdale
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Berry
mesh_terms: D000077:Acetabulum; D019644:Arthroplasty, Replacement, Hip; D001847:Bone Diseases / Q000175:diagnosis / Q000601:surgery*; D001860:Bone Plates; D006622:Hip Prosthesis; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging / Q000293:injuries; D007512:Ischium / Q000000981:diagnostic imaging / Q000293:injuries; D019857:Osteogenesis, Distraction; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011630:Pubic Bone / Q000000981:diagnostic imaging / Q000293:injuries; D012086:Reoperation