Pelvic discontinuity: a challenge to overcome

EFORT Open Reviews

article

George C. Babis¹  Vasileios S. Nikolaou¹ 

[1] 2nd Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio Hospital

关键词: arthroplasty;    hip;    outcomes;    pelvic discontinuity;    pelvic dissociation;    revision;    treatment;   

DOI  :  10.1302/2058-5241.6.210022

学科分类：神经科学

来源: The British Editorial Society of Bone & Joint Surgery

【 摘 要 】

Pelvic discontinuity (PD) has been a considerable challenge for the hip revision arthroplasty surgeon. However, not all PDs are the same. Some occur during primary cup insertion, resembling a fresh periprosthetic fracture that separates the superior and inferior portions of the pelvis, while others are chronic as a result of gradual acetabular bone loss due to osteolysis and/or acetabular implant loosening. In the past, ORIF, various types of cages, bone grafts and bone cement were utilized with little success. Today, the biomechanics and biology of PD as well as new diagnostic tools and especially a variety of new implants and techniques are available to hip revision surgeons. Ultraporous cups and augments, cup-cage constructs and custom triflange components have revolutionized the treatment of PD when used in various combinations with ORIF and bone grafts. For chronic PD the cup-cage construct is the most popular method of reconstruction with good medium-term results. Dislocation continues to be the leading cause of failure in all situations, followed by infection. Ultimately, surgeons today have a big enough armamentarium to select the best treatment approach. Case individualization, personal experience and improvisation are the best assets to drive treatment decisions and strategies.

【 授权许可】

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