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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 7, 870-876.
doi: 10.1302/0301-620X.91B7.22181  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Acetabular revision using an anti-protrusion (ilio-ischial) cage and trabecular metal acetabular component for severe acetabular bone loss associated with pelvic discontinuity

Y. Kosashvili, MD, MHA, Clinical Fellow in Lower Extremity Reconstruction1; D. Backstein, MD, MED, FRCSC, Associate Professor of Orthopaedic Surgery1; O. Safir, MD, MED, FRCSC, Orthopaedic Surgeon1; D. Lakstein, MD, Clinical Fellow in Lower Extremity Reconstruction1; and A. E. Gross, MD, FRCSC, Professor of Orthopaedic Surgery1

1 Division of Arthroplasty, Orthopaedic Department Mount Sinai Hospital, 600 University Avenue, University of Toronto, Ontario, Canada M5G 1X5.

Correspondence should be sent to Professor A. E. Gross; e-mail: allan.gross{at}utoronto.ca

Pelvic discontinuity with associated bone loss is a complex challenge in acetabular revision surgery. Reconstruction using ilio-ischial cages combined with trabecular metal acetabular components and morsellised bone (the component-cage technique) is a relatively new method of treatment.

We reviewed a consecutive series of 26 cases of acetabular revision reconstructions in 24 patients with pelvic discontinuity who had been treated by the component-cage technique. The mean follow-up was 44.6 months (24 to 68). Failure was defined as migration of a component of > 5 mm.

In 23 hips (88.5%) there was no clinical or radiological evidence of loosening at the last follow-up. The mean Harris hip score improved significantly from 46.6 points (29.5 to 68.5) to 76.6 points (55.5 to 92.0) at two years (p < 0.001). In three hips (11.5%) the construct had migrated at one year after operation. The complications included two dislocations, one infection and one partial palsy of the peroneal nerve.

Our findings indicate that treatment of pelvic discontinuity using the component-cage construct is a reliable option.




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K. Lingaraj, Y. H. Teo, and N. Bergman
The management of severe acetabular bone defects in revision hip arthroplasty using modular porous metal components
J Bone Joint Surg Br, December 1, 2009; 91-B(12): 1555 - 1560.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General