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Acetabular reconstruction in revision total hip arthroplasty.
George W Fryhofer1, Sireesh Ramesh2, Neil P Sheth3
1Orthopaedic Surgery Resident, University of Pennsylvania, Department of Orthopaedic Surgery, 3737 Market Street, Philadelphia, PA, 19104, USA.
Journal of Clinical Orthopaedics and Trauma
|February 1, 2020
Summary
Revision total hip arthroplasty (THA) presents challenges like acetabular bone loss. This review details patient evaluation, planning, and reconstruction methods, favoring uncemented techniques for better outcomes in complex cases.
Area of Science:
- Orthopaedic Surgery
- Arthroplasty
- Reconstructive Surgery
Background:
- Total hip arthroplasty (THA) procedures are increasing annually.
- Acetabular bone loss is a common challenge during revision THA surgery.
- Effective management requires thorough pre-operative evaluation and planning.
Purpose of the Study:
- To review current knowledge on acetabular reconstruction in revision THA.
- To discuss patient evaluation, classification of bone loss, and surgical techniques.
- To analyze clinical outcomes associated with different reconstruction methods.
Main Methods:
- Review of literature focusing on acetabular reconstruction in revision THA.
- Discussion of pre-operative assessment (clinical, radiographic, laboratory).
- Analysis of acetabular bone loss classification (Paprosky system) and reconstruction strategies (cemented vs. uncemented).
Main Results:
- The Paprosky classification system guides treatment strategy for acetabular bone loss.
- Both cemented and uncemented reconstruction techniques have advantages and disadvantages.
- Uncemented techniques promoting biologic fixation are generally preferred.
- Acetabular distraction is the preferred technique for pelvic discontinuity.
Conclusions:
- Successful acetabular reconstruction in revision THA relies on meticulous pre-operative assessment, planning, and team execution.
- Uncemented fixation methods are favored for their potential for biologic incorporation.
- Further long-term studies are needed to compare the longevity of various reconstruction techniques.
