Reconstruction options and outcomes for acetabular bone loss in revision hip arthroplasty

  • Fabio Mancino Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Giorgio Cacciola GIOMI Istituto Ortopedico del Mezzogiorno d’Italia Franco Scalabrino, Ganzirri, Messina, Italy.
  • Davide De Marco Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Alexander Greenberg Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York NY, United States.
  • Carlo Perisano Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
  • MA Malahias Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York NY, United States.
  • Peter K. Sculco Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York NY, United States.
  • Giulio Maccauro Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Ivan De Martino | ivan.demartino@policlinicogemelli.it Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Abstract

Revision total hip arthroplasty in the setting of acetabular bone loss is a challenging procedure and requires a solid understanding of current acetabular reconstruction options. Despite major developments in the field of revision hip surgery in recent decades, reconstruction of acetabular defects remains a major problem in order to achieve primary stability and durable fixation without sacrificing additional bone stock. Although there are several ways to classify acetabular bone defects, the Paprosky classification system is the most commonly used to describe the defects and guide treatment strategy. An understanding of the bone defects associated with detailed pre-operative assessment and planning are essential elements in order to achieve satisfactory outcomes. Multiple acetabular reconstructive options are currently available including impaction bone grafting with metal mesh, reinforcement rings and antiprotrusio cage, structural allografts, cementless hemispherical cups, extra-large “jumbo cups”, oblong cups, modular porous metal augments, cup-cage constructs, custom- made triflange cups, and acetabular distraction. To date, debate continues as to which technique is most effective due to the lack of long-term studies of modern reconstruction systems. Further long-term studies are necessary to assess the longevity of the different implants. The purpose of this study was to review the current literature and provide a comprehensive understanding of the available reconstruction options with their clinical outcomes.

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Published
2020-06-25
Keywords:
Spinopelvic alignment, total hip arthroplasty, hip-spine, pelvic tilt, dislocation.
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How to Cite
Mancino, F., Cacciola, G., De Marco, D., Greenberg, A., Perisano, C., Malahias, M., Sculco, P. K., Maccauro, G., & De Martino, I. (2020). Reconstruction options and outcomes for acetabular bone loss in revision hip arthroplasty. Orthopedic Reviews, 12(1s). https://doi.org/10.4081/or.2020.8655

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