Managing bone loss in acetabular revision.
ABSTRACT The management of bone loss encountered during acetabular revision remains challenging. In order to obtain a successful surgical result, preoperative planning is required to estimate the severity and location of bone defects. Most acetabular revisions can be treated with the use of a cementless hemispherical component. However, a successful surgical reconstruction requires component stability. Depending on the degree of bone loss, the surgical reconstruction may require the use of cancellous or structural bone graft, acetabular augmentation, an acetabular cage, a custom implant, or an acetabular transplant.
Article: [Functional outcomes in patients subjected to acetabular revision with reinforcement rings].[show abstract] [hide abstract]
ABSTRACT: Total hip arthroplasty is the most successful orthopedic procedure and the frequency of use of revision components has grown exponentially. The increased number of revisions results from the longer life expectancy of the population and the greater frequency of the hip arthroplasty indication among young patients. The purpose of this study is to evaluate the functional results of patients subjected to revision of the acetabular component using reinforcement rings. The study included patients with a diagnosis of septic or aseptic prosthetic loosening and sequelae of acetabular fractures between January 2007 and November 2009 in whom a reinforcement ring was used. The WOMAC scale was used for the functional evaluation. According to the WOMAC scale, the patient functionality results showed a mean preoperative score of 41.89 and a mean postoperative score of 74.26, which represented an improvement of 33.11 points in the median of patients subjected to the surgical intervention, with a statistically significant difference (p = 0.036). This study shows an improvement in the functionality of the patients subjected to surgery with a reinforcement ring, as, first and foremost, a statistically significant difference was seen between the preoperative and postoperative values and, secondly, there are papers published in the literature showing that a difference of more than 12 points between the preoperative and postoperative scores in the WOMAC scale indicates a significant clinical improvement of patients. Patients subjected to acetabular revision with a reinforcement ring together with cemented polyethylene have an improved quality of life after the surgical intervention.Acta ortopédica mexicana. 24(4):230-4.