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The Reconstruction of Periprosthetic Pelvic Discontinuity

  • Benedict A. Rogers, MA, MSc, FRCS(Orth)

      Affiliations

    • Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
    • Corresponding Author InformationReprint requests: Benedict A. Rogers, MA, MSc, FRCS(Orth), Benedict Rogers, 65 Lillian St, Suite 710, Toronto, ON, Canada M4S 0A1.
  • ,
  • Paul M. Whittingham-Jones, FRCS(orth)

      Affiliations

    • Department of Trauma and Orthopaedic Surgery, St George's Hospital, London, UK
  • ,
  • Philip A. Mitchell, FRCS(orth)

      Affiliations

    • Department of Trauma and Orthopaedic Surgery, St George's Hospital, London, UK
  • ,
  • Oleg A. Safir, MD, MEd, FRCSC

      Affiliations

    • Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
  • ,
  • Martin D. Bircher, FRCS

      Affiliations

    • Department of Trauma and Orthopaedic Surgery, St George's Hospital, London, UK
  • ,
  • Allan E. Gross, MD, FRCSC

      Affiliations

    • Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

Received 7 July 2011; accepted 13 December 2011. published online 10 February 2012.
Corrected Proof

Abstract 

The surgical techniques and outcomes of acetabular reconstruction for periprosthetic pelvic discontinuity cases are reported. The mean time to surgery for 9 patients with acute pelvic discontinuity was 16.3 days, with 8 patients (88%) having posterior column plating and a porous metal acetabular cup. No cases required revision surgery, with a mean follow-up of 34 months (range, 24-67 months). Of the 62 chronic pelvic discontinuity cases, 20 had an ilioischial cage, with a revision rate of 29%. There were 42 cup-cage reconstructions with an 8-year survivorship of 86.3%, with a mean follow-up of 35 months (range, 24-93 months). Stable reconstruction of chronic pelvic discontinuity was achievable by distraction using a cup-cage acetabular reconstruction; however, satisfactory stability of acute pelvic discontinuity was achieved with compression of the posterior column using screw augmentation of the acetabular shell supplemented by posterior column plating.

Keywords: pelvic discontinuity, acetabular revision, bone loss, ilioischial cage, cup cage

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 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.12.017.

 Supplementary material available at www.arthroplastyjournal.org.

PII: S0883-5403(11)00695-4

doi:10.1016/j.arth.2011.12.017

« BackThe Journal of Arthroplasty