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Related Experiment Videos

Safe screw placement in acetabular revision surgery.

R Meldrum1, R L Johansen

  • 1Department of Orthopedic Surgery, Indiana University, School of Medicine, Indianapolis, Indiana 46202-5111, USA. meldrum@iupui.edu

The Journal of Arthroplasty
|December 12, 2001
PubMed
Summary

The quadrant system for screw placement in hip revision surgery is mostly safe. However, the high hip center implant poses a risk in the superoposterior quadrant.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Revision hip arthroplasty with extensive bone loss may require allografting or specialized uncemented acetabular components.
  • Accurate screw placement is crucial for the stability of uncemented acetabular components.

Purpose of the Study:

  • To evaluate the safety and accuracy of the quadrant system for screw placement with various acetabular components used in hip revision surgery.
  • To identify potential risks associated with specific implant designs and positioning.

Main Methods:

  • Utilized 14 pairs of cadaver hemipelves, with soft tissues removed except for medial neurovascular structures.
  • Tested all screw holes for adherence to the quadrant system recommendations across different acetabular components (high hip center, jumbo, and 3 reinforcement rings).

Main Results:

  • The high hip center implant demonstrated a dangerous screw trajectory in the center and anterior aspect of the superoposterior quadrant.
  • All other tested acetabular components and their screw placements adhered to the recommended quadrant guidelines.

Conclusions:

  • The quadrant system is largely reliable for guiding screw placement in revision hip surgery.
  • Surgeons must exercise caution with the high hip center acetabular component due to a specific high-risk zone for screw placement.

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