Acetabular defect classification and management : Revision arthroplasty of the acetabular cup based on 3-point fixation.
Orthopade
; 49(5): 432-442, 2020 May.
Article
en En
| MEDLINE
| ID: mdl-32112227
ABSTRACT
BACKGROUND:
The purpose of this study was to provide a practicable and contemporary classification system that is reliable and pragmatic with respect to perioperative evaluation, planning, scientific comparison and analysis. MATERIAL ANDMETHODS:
This was a retrospective study of 160 patients who underwent acetabular revision surgery after THR due to loosening of the acetabular cup. The assessment of the acetabular defect was based on intraoperative description of the bony configuration of the acetabulum as well as on standardized preoperative planning images (pelvic overview and axial view of the hip joint). Preoperative computed tomography (CT) was carried out in individual cases.RESULTS:
Acetabular bone defects were classified into 4 types based on whether or not a 3-point fixation of the acetabular cup within the boundaries of the acetabular cavity was possible. Minor segmental defects or cup loosening without bone loss can be treated with standard hemispherical acetabular components. Bone loss can be filled with bone grafts and/or treated by the appropriate acetabular component in order to ensure stable anchorage. When conventional revision cups are no longer suitable a custom made partial pelvic replacement can be used.CONCLUSION:
The proposed classification mainly relies on intraoperative findings which were confirmed by preoperative imaging in 154 cases out of 160 (96.25%); however, meticulous preoperative planning based on Xray radiographs must be carried out. In addition, a CT scan must be performed whenever type III or type IV defects are anticipated. Compared to the existing classification systems, we can state that our classification system is practicable and pragmatic and simplifies the assessment of bone defects.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Artroplastia de Reemplazo de Cadera
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Procedimientos de Cirugía Plástica
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Articulación de la Cadera
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Prótesis de Cadera
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Acetábulo
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Orthopade
Año:
2020
Tipo del documento:
Article
País de afiliación:
Alemania