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Review
. 2018 Jan-Mar;9(1):58-62.
doi: 10.1016/j.jcot.2017.09.009. Epub 2017 Sep 18.

Treatment options for chronic pelvic discontinuity

Mark D Hasenauer  1 , Wayne G Paprosky  2 , Neil P Sheth  3
Affiliations
Review

Treatment options for chronic pelvic discontinuity

Mark D Hasenauer et al. J Clin Orthop Trauma. 2018 Jan-Mar.

Abstract

Chronic pelvic discontinuity is a distinct and unique challenge seen during revision total hip arthroplasty (THA) in which the superior ilium is separated from the inferior ischiopubic segment through the acetabulum, rendering the anterior and posterior columns discontinuous. The operative management of acetabular bone loss in revision THA is one of the most difficult challenges today. Common treatment options include cage reconstruction with bulk acetabular allograft, custom triflange acetabular component, a cup-cage construct, jumbo acetabular cup with porous metal augments, or acetabular distraction with a porous tantalum shell with or without modular porous augments.

Keywords: Acetabular bone loss; Acetabular distraction; Chronic pelvic discontinuity; Revision total hip arthroplasty.

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Figures

Fig. 1
Fig. 1
A distractor is used to assess motion at the fracture site.
Fig. 2
Fig. 2
Distractor is switched to an extra-acetabular position and reamed on reverse until the acetabulum is maximally distracted.
Fig. 3
Fig. 3
The reamer will disengage from the handle upon engaging the columns.
Fig. 4
Fig. 4
If correct sized trial is chosen, the superior and inferior hemi-pelvis will move as a unit.
See this image and copyright information in PMC

References

    1. Berry D.J., Lewallen D.G., Hanssen A.D., Cabanela M.E. Pelvic discontinuity in revision total hip arthroplasty. J Bone Joint Surg Am. 1999;81(12):1692–1702. - PubMed
    1. Kosashvili Y., Backstein D., Safir O., Lakstein D., Gross A.E. Acetabular revision using an anti-protrusion (ilio-ischial) cage and trabecular metal acetabular component for severe acetabular bone loss associated with pelvic discontinuity. J. Bone Joint Surg Brit. 2009;91-B(7):870–876. - PubMed
    1. Bozic K.J., Kurtz S.M., Lau E., Ong K., Vail T.P., Berry D.J. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91(1):128–133. - PubMed
    1. Kurtz S., Mowat F., Ong K., Chan N., Lau E., Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005;87(7):1487–1497. - PubMed
    1. Kurtz S., Ong K., Lau E., Mowat F., Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780–785. - PubMed

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