Original Article

HSS Journal

, Volume 4, Issue 2, pp 128-137

A Review of the Treatment of Pelvic Discontinuity

  • M. VillanuevaAffiliated withDepartment of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Marañón Email author 
  • , A. Rios-LunaAffiliated withDepartment of Orthopaedic Surgery and Traumatology, Hospital Virgen del MarNeuroscience and Health Science Department, University of Almeria
  • , J. Pereiro De LamoAffiliated withDepartment of Orthopaedic Surgery and Traumatology, Hospital Clínico Universitario
  • , H. Fahandez-SaddiAffiliated withDepartment of Orthopaedic Surgery and Traumatology, Hospital Fundación Alcorcón
  • , M. P. G. BöstromAffiliated withDepartment of Orthopaedic Surgery, Hospital for Special Surgery

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Abstract

Pelvic discontinuity is a complex entity with a high surgical complication rate and no standardized treatment to date. Revision hip arthroplasty in cases of massive bone loss remains a difficult and unsolved problem. The goal of the surgeon is to preserve limb function by restoring bone stock and the biomechanics of the hip. In cases of severe acetabular bone loss, biologic fixation is often inadequate, requiring extensive bone grafting and reconstructive cages. Reconstructive cages are the most commonly used devices and are designed to bridge bone defects, protect the bone graft, and reestablish the rotation center of the hip. A major limitation of current cages is that they do not allow for biologic fixation. We review the options for treating patients with massive bone loss and pelvic discontinuity and discuss therapeutic options and the clinical and radiological criteria for success.

Keywords

reconstructive cages massive bone loss revision hip arthroplasty pelvic discontinuity