Retention of a well-fixed acetabular component in the setting of acetabular osteolysis.
Summary of "Retention of a well-fixed acetabular component in the setting of acetabular osteolysis."
PURPOSE:
The treatment strategy for pelvic osteolysis with a well-fixed acetabular component after total hip arthroplasty (THA) involves replacing the acetabular cup liner and femoral head, débriding osteolytic lesions, and grafting.
METHODS:
We investigated whether retention of a well-fixed acetabular component using the two-approach technique-the ilioinguinal approach combined with the posterolateral approach-was compatible with socket survival. We reviewed clinical and radiographic findings for 24 patients (24 hips) who had undergone acetabular revision arthroplasty of a well-fixed socket for progressive osteolysis. The surgical techniques used included osteolytic lesion débridement and bone grafting through the ilioinguinal approach, and replacement of the acetabular liner and femoral head through the posterolateral approach.
RESULTS:
The mean duration of follow-up after revision was 2.3 (range 2.1-3.9) years. At follow-up evaluation, all acetabular components were well fixed and showed no evidence of loosening, osseous integration was apparent and there was no radiographic evidence that any lesions had progressed. No new osteolytic lesions were identified, and there were no clinical or radiographic complications.
CONCLUSIONS:
Curettage and bone grafting under direct vision, cup liner and femoral-head replacement because of progressive retroacetabular osteolysis and retention of well-fixed components using the two-approach technique results in good osseous integration of lysis. Larger studies with longer follow-up periods are required to establish the long-term success of this technique.
Affiliation
Department of Orthopaedics, West China Hospital, Sichuan University, 37 Guo-xue Lane, Wu-hou District, Chengdu, 610041, China, kangpd@163.com.
Journal Details
This article was published in the following journal.
Name: International orthopaedics
ISSN: 1432-5195
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22314642
- DOI: http://dx.doi.org/10.1007/s00264-011-1372-x
Medical and Biotech [MESH] Definitions
Osteoarthritis, Hip
Noninflammatory degenerative disease of the hip joint which usually appears in late middle or old age. It is characterized by growth or maturational disturbances in the femoral neck and head, as well as acetabular dysplasia. A dominant symptom is pain on weight-bearing or motion.
Hip Dislocation, Congenital
Congenital dislocation of the hip generally includes subluxation of the femoral head, acetabular dysplasia, and complete dislocation of the femoral head from the true acetabulum. This condition occurs in approximately 1 in 1000 live births and is more common in females than in males.
Cementation
The joining of objects by means of a cement (e.g., in fracture fixation, such as in hip arthroplasty for joining of the acetabular component to the femoral component). In dentistry, it is used for the process of attaching parts of a tooth or restorative material to a natural tooth or for the attaching of orthodontic bands to teeth by means of an adhesive.
Rate Setting And Review
A method of examining and setting levels of payments.
Acro-osteolysis
A condition with congenital and acquired forms causing recurrent ulcers in the fingers and toes. The congenital form exhibits autosomal dominant inheritance; the acquired form is found in workers who handle VINYL CHLORIDE. When acro-osteolysis is accompanied by generalized OSTEOPOROSIS and skull deformations, it is called HAJDU-CHENEY SYNDROME.
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