Abstract
Management of the acetabular deficiency in revision total hip arthroplasty (THA) or dysplastic hips (DDH) is a technical demanding procedure. Preoperatively, the acetabular deficiency must be assessed and classified into contained or uncontained defects. A contained defect may be reconstructed with morselized allografts and a noncemented acetabular component. Uncontained loss of bone stock involving ≤50% of the acetabulum can be reconstructed with structural or morselized allografts and noncemented acetabular component. In case of uncontained defect involving >50% of the acetabulum, with or without associated pelvic discontinuity, structural allografts in conjunction with a reconstruction cage may be required. In some occasions, the acetabular deficiency is so severe, and the host acetabular bed is poorly vascularized; autogenous iliac bone grafts may be required in the host-allograft junction to facilitate healing of the allografts. The general principles of this type of reconstruction include to restore the center of rotation of the hip joint, achieve stable fixation of the component, and restore the bone deficiency and adequate healing of the grafts to the host bone.
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References
D’Antonio JA, Capello WN, Borden LS, et al. Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop. 1989;(243):126–37.
Paprosky W, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. J Arthroplast. 1994;9:33–44.
Paprosky WG, Burnett RS, Martin EL. Current topics in revision total hip replacement: acetabular deficiency and its management. Tech Orthop. 2001;16:227–36.
Cabanela ME. Total hip arthroplasty: degenerative dysplasia of the hip. In: Lieberman JR, Berry DJ, editors. Advanced reconstruction. Hip. 1st ed. Rosemont, IL: American Academy of Orthopaedic Surgeons. p. 115–20.
Anderson MJ, Harris WH. Total hip arthroplasty with insertion of acetabular component without cement in patients with congenital dislocation or marked congenital dysplasia. J Bone Joint Surg Am. 1999;81-A:347–54.
Numair J, Joshi AB, Murphy JC, Porter ML, Hardinge K. Total hip arthroplasty for congenital dysplasia or dislocation of the hip: survivorship analysis and long-term results. J Bone Joint Surg Am. 1997;79-A:1352–60.
Wang JW, Fong CY, Su YS, Yu HN. Acetabular revision with morsellised allogenic bone graft and a cemented metal-backed component. J Bone Joint Surg Br. 2006;88-B:586–91.
Gerber A, Pisan M, Zurakowski D, Isler B. Ganz reinforcement ring for reconstruction of acetabular defects in revision total hip arthroplasty. J Bone Joint Surg Am. 2003;85-A:2358–64.
Bonnomet F, Clavert P, Gicquel P, Lefebvre Y, Kempf JF. Reconstruction by graft and reinforcement device in severe aseptic acetabular loosening: 10 years survivorship analysis [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2001;87:135–46.
Hsu CC, Hsu CH, Yen SH, Wang JW. Use of the Burch-Schneider cage and structural allografts in complex acetabular deficiency: 3- to 10- year followup. Kaohsiung J Med Sci. 2015;31:540–7.
Goodman S, Saastamoinen H, Shash N, Gross A. Complications of ilioischial reconstruction rings in revision total hip arthroplasty. J Arthroplasty. 2004;19:436–46.
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Wang, JW. (2018). Reconstruction of Acetabular Deficiency. In: Lai, KA. (eds) Developmental Dysplasia and Dislocation of the Hip in Adults. Springer, Singapore. https://doi.org/10.1007/978-981-13-0414-9_6
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DOI: https://doi.org/10.1007/978-981-13-0414-9_6
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