Acetabular Distraction Technique: A Multicenter Study With a Minimum 2-Year Radiographic Follow-Up

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Chronic pelvic discontinuity presents significant challenges in revision total hip arthroplasty due to severe acetabular bone loss.
• Acetabular distraction offers an alternative surgical approach by stabilizing the acetabular component through pelvic elastic recoil.
• This technique can be augmented with modular porous augments for substantial acetabular defects.

Purpose of the Study:

• To report 2-year radiographic findings of acetabular distraction for treating chronic pelvic discontinuity.
• To evaluate the efficacy and outcomes of acetabular distraction in patients with severe acetabular bone loss.

Main Methods:

• A retrospective study identified 91 patients undergoing acetabular distraction by 5 surgeons across 5 institutions (2002-2021).
• 53 patients (mean follow-up 4.8 years) with Paprosky IIIB defects (77.4%) were included; 62.3% received modular porous augments.
• Failure was defined as subsequent revision of the acetabular construct.

Main Results:

• Overall cup survivorship was 90.6%, with only 9.4% of patients requiring acetabular revision post-procedure.
• Of the 48 evaluable patients, 95.8% demonstrated radiographic bridging callus at the chronic pelvic discontinuity.
• 13 patients (24.5%) required reoperation, with 46.2% having prior revision hip arthroplasty.

Conclusions:

• Acetabular distraction is a viable treatment for acetabular bone loss associated with chronic pelvic discontinuity.
• The procedure demonstrates excellent early survivorship and radiographic evidence of bone healing (bridging callus).
• Longer follow-up studies are necessary to further assess the long-term efficacy of this technique.