This article summarises a clinical and radiographical analysis of 30 acetabular revisions in patients younger than 55 years old, performed with impaction bone grafting and cemented cups. Preoperative Merle D'Aubigne and Postel functional score was an average 7 points. At a mean follow-up of 86.5 months (range 34-228) functional score averaged 16.3 points. Radiolucent lines with no clinical impact were observed in 7% of DeLee and Charnley acetabular zones evaluated. Massive radiological migration, consistent with clinical failure, was observed in two cups. Three patients underwent re-revision surgery (10%): two due to infection and one due to mechanical failure. Reconstruction survival rate was 89% (CI 95% 71.9-96.4) overall, and 96% (CI 95% 82.6-99.3) ruling out cases of infection. Impacted bone allograft constitutes one of the reconstructive techniques of choice in acetabular revision surgery of young patients. Restoration of bone stock is essential in this group of patients due to the possibility of future revisions.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903100 | PMC |
http://dx.doi.org/10.1007/s00264-007-0503-x | DOI Listing |
JBJS Case Connect
January 2025
Department of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Case: Triple pelvic osteotomy (TPO) is used to treat developmental dysplasia of the hip in a pediatric population. This case report highlights a new indication for this procedure. Acetabular coverage was restored in a 9-year-old patient who experienced instability following hip hemiarthroplasty and proximal femur composite allograft implantation for the treatment of Ewing sarcoma.
View Article and Find Full Text PDFArthroplast Today
February 2025
Department of Orthopaedic Surgery, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, Australia.
Background: Dual mobility (DM) implants in total hip arthroplasty provide excellent range of motion with low dislocation rates. A complication of this design is intraprosthetic dislocation (IPD), where the polyethylene (PE) liner dissociates from the femoral head. In older designs, IPD occurred due to a small head size and late PE wear with head-capture-mechanism failure.
View Article and Find Full Text PDFIowa Orthop J
January 2025
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Background: Dislocation remains a common complication following total hip arthroplasty (THA). Previous literature has shown that the femoral head-to-neck ratio is essential in hip motion, function, and stability. While large femoral heads and dual mobility bearings have been developed to improve stability, it remains unknown if the ratio between femoral head size to acetabular cup size also plays a role in stability.
View Article and Find Full Text PDFZ Orthop Unfall
January 2025
Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
The treatment of acetabular defects in revision arthroplasty is an increasing challenge. Different classifications have been introduced for preoperative planning to achieve the best possible result. 3D printing is a way to better visualize and understand these defects.
View Article and Find Full Text PDFJ Orthop Case Rep
January 2025
Department of Orthopaedic, Sunshine Bone and Joint Insitute, KIMS-Sunshine Hospitals, Hyderabad, Telangana, India.
Introduction: Total hip arthroplasty (THA) is recognized as one of the most effective surgical procedures for the treatment of end-stage hip arthritis. However, the increasing number of primary THA cases has led to a corresponding rise in the frequency of revision surgeries, which are often more complex and challenging due to severe acetabular bone loss. In such cases, managing Paprosky type 3A and 3B defects requires precise implant design and advanced surgical techniques.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!