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Early postoperative acetabular discontinuity after total hip arthroplasty
1Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California 94143, USA.
The Journal of Arthroplasty
|March 5, 2011
Summary
Elderly patients with severe osteoporosis face a risk of acetabular discontinuity after total hip arthroplasty (THA). This study shows cemented cage reconstruction with bone grafting can salvage acetabular fixation in these rare cases.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Complications
- Geriatric Orthopedics
Background:
- Total hip arthroplasty (THA) is a common procedure for hip joint issues.
- Periprosthetic acetabular fractures are rare but serious complications following THA.
- Elderly patients, particularly those with osteoporosis, may be at higher risk.
Observation:
- Two cases of acute postoperative acetabular discontinuity occurred 2 and 3 weeks after primary THA.
- Both patients were elderly females with severe osteoporosis and experienced minimal trauma.
- These fractures may have originated from unrecognized intraoperative injuries.
Findings:
- Pelvic stability was successfully restored in both patients.
- Acetabular revision was performed using medial morselized bone grafting and a cemented reconstruction cage.
- This surgical approach effectively salvaged acetabular fixation.
Implications:
- Early postoperative acetabular discontinuity is a significant risk in osteoporotic elderly patients undergoing THA.
- Cemented cage reconstruction combined with medial morselized bone grafting is a viable salvage strategy.
- This technique can restore pelvic stability and acetabular fixation in complex cases.