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THE CEMENTED DOUBLE MOBILITY CUP IN HIP REVISION: DIFFERENT POSSIBILITIES OF USE.

Acta ortopedica brasileira·2023
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ACETABULAR RECONSTRUCTION IN PAPROSKY TYPE III DEFECTS.

Jaime J Morales De Cano1, Llorenç Guillamet1, Arturo Perez Pons1

  • 1Hospital Universitario de Vic, Orthopaedic Surgery, Vic, Barcelona, Spain.

Acta Ortopedica Brasileira
|February 19, 2019
PubMed
Summary

This study shows that combining bone allografts with a Bursch-Schneider anti-protrusion cage effectively reconstructs severe acetabular defects in hip revision surgery. Restoring the hip

Keywords:
Joint revisionbone grafthip arthroplastyreconstructive surgical procedure

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Biomaterials in Orthopedics

Background:

  • Severe pelvic deficiency poses significant challenges in hip arthroplasty, particularly in acetabular reconstruction.
  • Restoring pelvic bone stock, achieving correct acetabular component placement, and optimizing joint stability are critical goals.
  • Existing surgical techniques for acetabular defects lack a definitive consensus on optimal treatment.

Purpose of the Study:

  • To evaluate the mid-term efficacy of bone allografts combined with a Bursch-Schneider anti-protrusion cage (BSAC) for severe acetabular bone defects (Paprosky type III).
  • To assess the ability of this technique to restore the anatomical center of rotation of the hip.

Main Methods:

  • Retrospective review of 23 consecutive complex acetabular reconstructions.
  • Procedures performed between 2006 and 2011, including the initial learning curve.
  • Minimum 5-year follow-up for all cases.

Main Results:

  • The combination of frozen morselized allograft and a metal ring-type BSAC demonstrated efficacy in acetabular reconstruction.
  • Restoration of the anatomical center of rotation is crucial for long-term success in hip revision.
  • Bone grafting protected by a ring effectively reconstructs bone density and improves acetabular component centering in cases of massive loosening.

Conclusions:

  • Frozen morselized allograft with a BSAC is an effective method for acetabular reconstruction in severe bone defects.
  • Re-establishing the anatomical center of rotation is paramount for successful hip arthroplasty revision.
  • This technique aids in restoring bone stock and improving component stability for complex acetabular deficiencies.