Pelvic discontinuity: a challenge to overcome

Pelvic discontinuity (PD) has been a considerable challenge for the hip revision arthroplasty surgeon. However, not all PDs are the same. Some occur during primary cup insertion, resembling a fresh periprosthetic fracture that separates the superior and inferior portions of the pelvis, while others are chronic as a result of gradual acetabular bone loss due to osteolysis and/or acetabular implant loosening. In the past, ORIF, various types of cages, bone grafts and bone cement were utilized with little success. Today, the biomechanics and biology of PD as well as new diagnostic tools and especially a variety of new implants and techniques are available to hip revision surgeons. Ultraporous cups and augments, cup-cage constructs and custom triflange components have revolutionized the treatment of PD when used in various combinations with ORIF and bone grafts. For chronic PD the cup-cage construct is the most popular method of reconstruction with good medium-term results. Dislocation continues to be the leading cause of failure in all situations, followed by infection. Ultimately, surgeons today have a big enough armamentarium to select the best treatment approach. Case individualization, personal experience and improvisation are the best assets to drive treatment decisions and strategies. Cite this article: EFORT Open Rev 2021;6:459-471. DOI: 10.1302/2058-5241.6.210022

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New technique of two-stage hip revision arthroplasty using digital polarization and laser-induced autofluorescence microscopy and intraoperatively produced second generation spacers

TRAUMA ◽

10.22141/1608-1706.3.21.2020.208418 ◽

2020 ◽

Vol 21 (3) ◽

pp. 20-32

Author(s):

V.L. Vasyuk ◽

Y.M. Vasylchyshyn ◽

V.V. Protsiuk

Keyword(s):

Second Generation ◽

Revision Arthroplasty ◽

New Technique ◽

Two Stage ◽

Hip Revision ◽

Hip Revision Arthroplasty

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beta2-microglobulin amyloid deposition in hip revision arthroplasty tissues

Histopathology ◽

10.1046/j.1365-2559.1998.00546.x ◽

1998 ◽

Vol 33 (5) ◽

pp. 479-484 ◽

Cited By ~ 14

Author(s):

R Crawford ◽

N A Athanasou

Keyword(s):

Revision Arthroplasty ◽

Amyloid Deposition ◽

Hip Revision ◽

Hip Revision Arthroplasty

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Comparison of contamination of femoral heads and pre-processed bone chips during hip revision arthroplasty

Cell and Tissue Banking ◽

10.1007/s10561-013-9362-4 ◽

2013 ◽

Vol 14 (4) ◽

pp. 615-620 ◽

Cited By ~ 3

Author(s):

N. M. C. Mathijssen ◽

P. D. Sturm ◽

P. Pilot ◽

R. M. Bloem ◽

P. Buma ◽

...

Keyword(s):

Revision Arthroplasty ◽

Hip Revision ◽

Hip Revision Arthroplasty ◽

Femoral Heads

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Results of Cemented Femur Components Application at Total Hip Revision Arthroplasty

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto20120332-38 ◽

2012 ◽

Vol 19 (3) ◽

pp. 32-38

Author(s):

N. V Zagorodniy ◽

V. I Nuzhdin ◽

K. M Bukhtin ◽

S. V Kagramanov

Keyword(s):

Revision Arthroplasty ◽

Treatment Results ◽

Indication For Surgery ◽

Hip Revision ◽

Hip Revision Arthroplasty ◽

Total Hip ◽

Level 1 ◽

Type 3 ◽

Fatigue Fractures

Treatment results for 114 total hip revision arthroplasties (1992—2011) with cemented femur components were analyzed. The most common indication for surgery was aseptic instability of hip implant. In 1 st group (42 operations) cemented stems Bi-Metric (Biomet Orthopaedics) and in 2 nd group (72 operations) cemented stems ESI (Endoservis) were used. Surgical technique was described and causes of complication development were analyzed. Mean follow-up made up 11 years. In the 1 st group excellent results were achieved in 2 (4.76%) cases, good in 34 (80.95%), satisfactory in 3 (7.14%) and poor in 3 (7.14%) cases. In the 2 nd group corresponding results were achieved in 3 (4.17%), 47 (65.28%), 15 (20.83%) and 7(9.72) respectively. Analysis of the reasons for complication development was performed. It was stated that femur defects of type 3 on level 1 by AAOS classification resulted in fatigue fractures of cemented revision stems.

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