Garín ZDE, Oseguera OA, Acosta EO

Language: Spanish
References: 27
Page: 198-205
PDF size: 174.24 Kb.

ABSTRACT

The management of acetabular defects in revision total hip arthroplasty is a complex procedure. These defects are mainly caused by osteolysis, bone resorption and iatrogenic. Conventional radiographic studies provide valuable information to understand the type of defect, however more specific studies such as CT scan may be necessary in some cases. Obtaining an adequate diagnosis by image allows us to classify the type of defect and to carry out an adequate pre-operative planning and treatment. It is very important to be aware of the therapeutic options available. Several types of grafts and implants have being used for acetabular bone defects such as impactation bone graft, structural bone allograft, mega cups, oblong cups, reinforcement and reconstruction cages, and the more recently metal augments. All of them have proven their effectiveness when used correctly.

REFERENCES

1. Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994; 9: 33.

2. Daivajna SC, Duncan CP, Masri BA, Garbuz DS. Highly porous metal shells and augments in revision hip surgery: Big hopes for big holes. Seminars in Arthroplasty. 2015; 26: 181-185.

3. Burgo FJ, Vindver GI, Paprosky WG, Rosenberg AG. Revisión acetabular: métodos de reconstrucción , indicaciones y resultados. Rev Asoc Arg Ortop Traumatol. 2002; 67 (2): 130-140.

4. Whitehouse MR, Masri BA, Garbuz DS. Continued good results with modular trabecular metal augments for acetabular defects in hip arthroplasty
at 7 to 11 years. Clin Orthop Relat Res. 2015; 473: 521-527.

5. O’Neill C, Creedon S, Brennan S, O’Mahony F, Lynham R, Guerin S, et al. Acetabular revision using trabecular metal augments for Paprosky type 3 defects. J Arthroplasty. 2017; 33 (3): 823-828.

6. Schreurs BW, Keurentjes JC, Gardeniers JW, Verdonschot N, Slooff TJ, Veth RP. cetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component: a 20­ to 25­year follow­up. J Bone Joint Surg Br. 2009; 91: 1148-1153.

7. Sporer SM, Paprosky WG. The use of a trabecular metal acetabular component and trabecular metal augment for severe acetabular defects. J Arthroplasty. 2006; 21 (Suppl. 2): 83-86.

8. Schreurs BW, Luttjeboer J, Thien TM, De Waal Malefijt MC, Buma P, Veth RP, et al. Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis: a concise follow­up, at eight to nineteen years, of a previous report. J Bone Joint Surg Am. 2009; 91: 646-651.

9. Sporer SM, O’Rourke M, Chong P, Paprosky WG. The use of structural distal femoral allografts for acetabular reconstruction: average ten­year follow­up. J Bone Joint Surg Am. 2005; 87: 760-765.

10. Jasty M, Harris WH. Salvage total hip reconstruction in patients with major acetabular bone de ciency using structural femoral head allografts. J Bone Joint Surg Br. 1990; 72: 63-67.

11. Emerson RH Jr, Head WC. Dealing with the deficient acetabulum in revision hip arthroplasty: the importance of implant migration and use of the jumbo cup. Semin Arthroplasty. 1993; 4: 2-8.

12. Gustke KA, Levering MF, Miranda MA. Use of jumbo cups for
revision of acetabular with large bony defects. J Arthroplasty. 2013; 29: 199-203.

13. Patel JV, Masonis JL, Bourne RB, Rorabeck CH. The fate of cementless jumbo cups in revision hip arthroplasty. J Arthroplasty. 2003; 18: 129-133.

14. Bozic KJ, Freiberg AA, Harris WH. The high hip center. Clin Orthop. 2004; (420): 101-105.

15. Jasty M: Jumbo cups and morselized graft. Orthop Clin North Am. 1998; 29: 249-254.

16. Udomkiat P, Dorr LD, Won YY, Longjohn DB, Wan Z. Technical factors for success with metal ring acetabular reconstruction. J Arthroplasty. 2001; 16: 961-969.

17. Perka C, Ludwig R. Reconstruction of segmental defects during revision procedures of the acetabulum with the Burch­Schneider anti­protrusio cage. J Arthroplasty. 2001; 16: 568-574.

18. Paprosky W, Sporer S, O’Rourke MR. The treatment of pelvic discontinuity with acetabular cages. Clin Orthop Relat Res. 2006; 453: 183-187.

19. Kosashvili Y, Backstein D, Safir O, Lakstein D, Gross AE. Acetabular revision using an anti­protrusion (ilio­ischial) cage and trabecular metal acetabular component for severe acetabular bone loss associated with pelvic discontinuity. J Bone Joint Surg Br. 2009; 91: 87-876.

20. Chen WM, Engh CA, Hopper RH, McAuley JP. Acetabular revision with use of a bilobed component inserted without cement in patients who have acetabular bone-stock deficiency. J Bone Joint Surg Am. 2000; 82: 197-206.

21. DeBoer DK, Christie MJ. Reconstruction of the deficient acetabulum with an oblong prosthesis: three to seven year results. J Arthroplasty. 1998; 13: 674-680.

22. Moskal JT, Higgins ME, Shen J. Type III acetabular defect revision with bilobed components: five year results. Clin Orthop Relat Res. 2008; 466: 691-695.

23. Köster G, Willert HG, Köhler HP, Döpkens K. An oblong revision cup for large acetabular defects: design rationale and two­ to seven­year follow­up. J Arthroplasty. 1998; 13: 559-569.

24. Meneghini RM, Meyer C, Buckley CA, Hanssen AD, Lewallen DG. Mechanical 
stability of novel highly porous metal acetabular components in revision total 
hip arthroplasty. J Arthroplasty. 2010; 25: 337.

25. Dwivedi C, Gokhale S, Gon Khim H, Keon OJ, Yong SW. Acetabular defect reconstruction with trabecular metal augments. Hip Pelvis. 2017; 29 (3): 168-175.

26. Steven Borland W, Bhattacharya R, James P Holland JP, Nigel Brewster NT. Use of porous trabecular metal augments with impaction bone grafting in management of acetabular bone loss: Early to medium-term results, Acta Orthopaedica. 2012; 83 (4): 347-352.

27. Lakstein D, Backstein D, Safir O, Kosashvili Y, Gross AE. Trabecular metalTM cups for acetabular defects with 50% or less host bone contact. Clin Orthop Relat Res. 2009; 467: 231-324.