The use of wire mesh in total hip replacement surgery

Metal mesh is helpful in relation to two complications of total hip replacement; namely, migration of the trochanter and fatigue fracture of the medial wall of the acetabulum. Mesh is applied over the greater trochanter in instances when the trochanter is excessively porotic and would crush as the wires are tightened. It is used to "recapture" the trochanter or trochanteric fragments if migration has occurred. The wires are then brought through the mesh and tied over the mesh, thus distributing the load widely across the porotic trochanter. The problem of a thin medial acetabular wall is dealt with by medially embedding a hemisphere of metal mesh in the methacrylate creating the effect of reinforced concrete. This increases the physical properties of the methacrylate and helps to distribute the load to the public, ischial and iliac portions of the socket. Potentially this approach will be useful in treating fatigue fractures of the medial acetabular wall after total hip replacement. Thirteen patients treated using chrome cobalt metal mesh in association with total hip replacement are presented.