Severe pelvic bone loss treated using a coned acetabular prosthesis with a stem extension inside the ilium

Area of Science:

• Orthopedic Surgery
• Oncology
• Arthroplasty

Background:

• Major acetabular defects pose significant challenges in reconstruction.
• Complex cases include periacetabular metastases and revision hip arthroplasty.
• Existing techniques may have limitations in severe bone loss scenarios.

Purpose of the Study:

• To describe a modified surgical technique for acetabular reconstruction using a stemmed-cone prosthesis.
• To report the early clinical outcomes of this novel approach.
• To evaluate its efficacy in oncological and complex arthroplasty cases.

Main Methods:

• A single surgeon performed 28 acetabular reconstructions using a stemmed-cone acetabular prosthesis.
• Procedures involved patients with periacetabular metastases (n=15) and complex arthroplasty needs (n=13).
• Defects were classified using the Paprosky system; all surgeries were performed without fluoroscopy via an extended posterior hip approach.

Main Results:

• Mean operative time was 133 minutes with no intraoperative complications.
• 14% of patients experienced postoperative complications at a mean follow-up of 12.5 months.
• No failures were observed in patients with pelvic discontinuity.

Conclusions:

• The stemmed-cone acetabular prosthesis offers a viable solution for acetabular reconstruction.
• This technique is effective for complex oncological and hip arthroplasty cases, including pelvic discontinuity.
• Early clinical outcomes suggest this modified technique is a useful option for challenging acetabular reconstructions.