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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 1, 84-87.
doi: 10.1302/0301-620X.90B1.19892  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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The three-pin modified ‘Harrington’ procedure for advanced metastatic destruction of the acetabulum

R. M. Tillman, FRCS, Consultant Orthopaedic Oncology Surgeon1; G. J. C. Myers, FRCS, Orthopaedic Specialist Registrar1; A. T. Abudu, FRCS, Consultant Orthopaedic Oncology Surgeon1; S. R. Carter, FRCS, Consultant Orthopaedic Oncology Surgeon1; and R. J. Grimer, FRCS, Consultant Orthopaedic Oncology Surgeon1

1 Royal Orthopaedic Hospital, Bristol Road South, Birmingham B31 2AP, UK.

Correspondence should be sent to Mr R. M. Tillman; e-mail: Roger.Tillman{at}roh.nhs.uk

Pathological fractures due to metastasis with destruction of the acetabulum and central dislocation of the hip present a difficult surgical challenge. We describe a series using a single technique in which a stable and long-lasting reconstruction was obtained using standard primary hip replacement implants augmented by strong, fully-threaded steel rods with cement and steel mesh, where required.

Between 1997 and 2006, 19 patients with a mean age of 66 years (48 to 83) were treated using a modified Harrington technique. Acetabular destruction was graded as Harrington class II in six cases and class III in 13.

Reconstruction was achieved using three 6.5 mm rods inserted through a separate incision in the iliac crest followed by augmentation with cement and a conventional cemented Charnley or Exeter primary hip replacement. There were no peri-operative deaths. At the final follow-up (mean 25 months (5 to 110)) one rod had fractured and one construct required revision. Of the 18 patients who did not require revision, 13 had died. The mean time to death was 16 months (5 to 55). The mean follow-up of the five survivors was 31 months (18 to 47). There were no cases of dislocation, deep infection or injury to a nerve, the blood vessels or the bladder.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General