TITLE

Revision Total Hip Arthroplasty for Pelvic Discontinuity

AUTHOR(S)
DeBoer, David K.; Christie, Michael J.; Brinson, Martha F.; Morrison, I. Craig
PUB. DATE
April 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Apr2007, Vol. 89-A Issue 4, p835
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Revision of a failed total hip arthroplasty with massive acetabular bone loss and pelvic discontinuity is a reconstructive challenge. This report presents the mid-term to long-term results of revision total hip arthroplasty with a custom-made porous-coated triflange acetabular prosthesis in a consecutive series of patients with pelvic discontinuity. Methods: Twenty-eight consecutive patients (thirty hips) with a failed total hip arthroplasty and pelvic discontinuity underwent revision total hip arthroplasty. The prosthesis was custom-manufactured on the basis of a three-dimensional model of the hemipelvis created with computed tomography. Initial stability of the implant was provided with screw fixation. Two patients did not return for follow-up after three months, and eight died and were followed for less than seven years, leaving twenty hips in eighteen patients followed for a mean of ten years. Harris hip scores and sequential radiographs were used to evaluate the clinical and radiographic results. Results: Definite healing of the pelvic discontinuity was indicated by the presence of bridging callus in eighteen of the twenty hips. There were no broken screws and no cases of implant migration, even when the discontinuity persisted. Small nonprogressive radiolucent lines were observed in six hips. Complications included one partial sciatic nerve palsy that resolved completely and one case of loose ischial screws in a radiographically stable implant in the same patient. Five patients had one or more dislocations postoperatively. The mean Harris hip score improved from 41 points preoperatively to 80 points at the time of the latest follow-up. Eleven of the eighteen patients required ambulatory aids postoperatively. No component was revised. Conclusions: Performance of a revision total hip arthroplasty with a custom triflange acetabular prosthesis to treat massive acetabular bone loss and pelvic discontinuity can provide a durable solution with good clinical results.
ACCESSION #
24694016

 

Related Articles

  • Strategies for head and inlay exchange in revision hip arthroplasty. Pospischill, Martin; Knahr, Karl // International Orthopaedics;Feb2011, Vol. 35 Issue 2, p261 

    Due to the increasing number of total hip arthroplasties performed during the last three decades and the limited long-term survival, mainly because of wear, the number of revisions has increased during the last two years. If the implant itself is still considered to be stable, only head and...

  • REVISION OF THE ACETABULAR COMPONENT WITHOUT CEMENT AFTER TOTAL HIP ARTHROPLASTY. Della Valle, Craig J.; Shuaipaj, Tasin; Berger, Richard A.; Rosenberg, Aaron G.; Shott, Susan; Jacobs, Joshua J.; Galante, Jorge O. // Journal of Bone & Joint Surgery, American Volume;Aug2005, Vol. 87-A Issue 8, p1795 

    Abstract: We previously reported our results at a minimum of three and seven years after use of a porous-coated acetabular metal shell in a consecutive series of 138 revision total hip arthroplasties. The current report presents the longer-term outcomes of these procedures, at fifteen to...

  • PREOPERATIVE PLANNING FOR REVISION TOTAL HIP ARTHROPLASTY. Barrack, Robert L.; Burnet, R. Stephen J. // Journal of Bone & Joint Surgery, American Volume;Dec2005, Vol. 87-A Issue 12, p2800 

    This article informs that perioperative complications and unexpected surgical findings are much more common in revision total hip arthroplasty than they are in primary total hip arthroplasty. There are often problems during surgery that require special instruments, implants, bone grafts, or...

  • Recurrent intrapelvic cyst complicating metal-on-metal cemented total hip arthroplasty. Madan, Sanjeev; Jowett, Richard L.; Goodwin, Mark I. // Archives of Orthopaedic & Trauma Surgery;Sep2000, Vol. 120 Issue 9, p508 

    Spontaneous intrapelvic masses causing vascular compression raise the suspicion of a neoplasm or infection. We present a patient who developed a recurrent intrapelvic cyst 14 years after a McKee-Farrar total hip arthroplasty which presented as acute onset of lower limb swelling, threatening the...

  • Fracturas periprotésicas de cadera. Sauri-Arce, J. C. A.; Azcona-Cervera, R. // Acta Ortopedica Mexicana;Mar/Apr2014, Vol. 28 Issue 2, p77 

    The incidence rate of peripros-thetic fractures has increased in the past decade. Osteolysis, age and preoperative function are factors that influence morbidity. Treatment options include conservative and surgical treatment. Objectives: To conduct a study analyzing the functional results of the...

  • The Patulous Proximal Femur. Cameron, Hugh U. // Orthopedics;Sep2005 Supplement, Vol. 28, ps1105 

    Patients with patulous proximal femurs who have hip revision surgery can be treated with reduction osteotomies or with large ingrowth sleeves used with proximally modular stems. Three hundred nine patients had hip revision with >5-years' follow-up (mean 8.6 years). Reduction osteotomies were...

  • The Use of Long Cemented Stems for Femoral Impaction Grafting in Revision Total Hip Arthroplasty. Sierra, Rafael J.; Charity, John; Tsiridis, Eleftherios; Timperley, John A.; Gie, Graham A. // Journal of Bone & Joint Surgery, American Volume;Jun2008, Vol. 90-A Issue 6, p1330 

    Background: Following revision total hip arthroplasty involving femoral impaction grafting, fractures usually have occurred distal to a standard-length stem in an area of weakened bone that was left inadequately supported. The purpose of the present study was to determine whether the use of a...

  • Acetabular revisions using a cementless oblong cup: five to ten year results. R. Civinini; A. Capone; C. Carulli; M. Villano; M. Gusso // International Orthopaedics;Apr2008, Vol. 32 Issue 2, p189 

    Abstract  The purpose of this paper was to evaluate the results of acetabular revisions with the use of an oblong revision cup that is designed with its longitudinal diameter elongated relative to its transverse diameter. Between 1996 and 2001, 62 hips in 60 patients underwent an...

  • Early Catastrophic Failure of a Porous-Coated Acetabular Cup due to Bead Shedding. A Case Report. HSU, ANDREW R.; VAUGHN, ZACKARY; HUDDLESTON, JAMES I. // Hip International;Oct-Dec2009, Vol. 19 Issue 4, p392 

    We present a patient in whom an uncemented porous-coated acetabular cup underwent early catastrophic failure due to debonding and was successfully managed with a revision total hip arthroplasty. Early bead shedding of an acetabular cup leading to a sudden component failure requiring revision...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics