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Pelvic reconstruction for massive acetabular insufficiency.

Shital N Parikh¹, Hans J Kreder

¹Sunnybrook & Women's College Health Science Centre, Toronto, Ontario, Canada.

Clinical Orthopaedics and Related Research

|May 3, 2005

Summary

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Anterograde Steinmann pins offer a safe and effective method for hip reconstruction in cases of pelvic discontinuity. This technique minimizes implant failure and neurovascular complications, improving patient mobility.

Area of Science:

Orthopedic Surgery
Reconstructive Surgery

Background:

Pelvic discontinuity with acetabular insufficiency poses significant surgical challenges.
Retrograde Steinmann pins for dome reconstruction risk early failure and neurovascular injury due to limited stability and placement issues.

Purpose of the Study:

To evaluate the mechanical failure and complication rates of anterograde Steinmann pin placement for hip reconstruction.
To assess the safety and efficacy of this technique in reinforcing cemented acetabular reconstructions for pelvic discontinuity.

Main Methods:

A retrospective review of nine patients (10 hips) treated between 1996 and 2002.
Utilized anterograde Steinmann pins placed from the iliac crest across acetabular defects, combined with a posterior hip approach and cemented roof ring reconstruction.

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No fluoroscopy was used during pin placement.

Main Results:

No instances of implant loosening or mechanical failure were observed.
Zero neurovascular complications and no perioperative deaths occurred.
One patient required revision surgery for recurrent dislocation; all patients achieved independent household walking within six weeks.

Conclusions:

Anterograde placement of large Steinmann pins provides a stable and effective reinforcement for acetabular reconstructions in pelvic discontinuity.
This technique is safe, avoiding fluoroscopy and minimizing risks associated with retrograde pin placement.
The method facilitates successful hip reconstruction, leading to significant functional recovery in severely affected patients.