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acetabular reconstruction

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https://www.readbyqxmd.com/read/28074234/-biological-downsizing-acetabular-defect-reconstruction-in-revision-total-hip-arthroplasty
#1
S Koob, S Scheidt, T M Randau, M Gathen, M D Wimmer, D C Wirtz, S Gravius
BACKGROUND: Periacetabular bony defects remain a great challenge in revision total hip arthroplasty. After assessment and classification of the defect and selection of a suitable implant the primary stable fixation and sufficient biological reconstitution of a sustainable bone stock are essential for long term success in acetabular revision surgery. Biological defect reconstruction aims for the down-sizing of periacetabular defects for later revision surgeries. TECHNIQUE: In the field of biological augmentation several methods are currently available...
January 10, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28066738/ligamentum-teres-tendinopathy-and-tears
#2
REVIEW
Matthew J Kraeutler, Tigran Garabekyan, Cecilia Pascual-Garrido, Omer Mei-Dan
BACKGROUND: The ligamentum teres (LT) consists of two bands that originate on the ischial and pubic sides of the acetabular notch and insert on the fovea capitis of the femoral head. Recent studies have established the LT as an important hip stabilizer in a squatting position, particularly in patients with osseous instability. PURPOSE: This review aims to concisely present the literature on LT tendinopathy and tears in order to guide health care professionals in the appropriate diagnosis and treatment of these disorders...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28063078/analysis-of-acetabular-orientation-and-femoral-anteversion-using-images-of-three-dimensional-reconstructed-bone-models
#3
Jaeyeong Park, Jun-Young Kim, Hyun Deok Kim, Young Cheol Kim, Anna Seo, Minkyu Je, Jong Uk Mun, Bia Kim, Il Hyung Park, Shin-Yoon Kim
PURPOSE: Radiographic measurements using two-dimensional (2D) plain radiographs or planes from computed tomography (CT) scans have several drawbacks, while measurements using images of three-dimensional (3D) reconstructed bone models can provide more consistent anthropometric information. We compared the consistency of results using measurements based on images of 3D reconstructed bone models (3D measurements) with those using planes from CT scans (measurements using 2D slice images)...
January 6, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28054110/-periprosthetic-acetabular-fractures-in-geriatric-patients
#4
S C Herath, M F R Rollmann, T Histing, J H Holstein, T Pohlemann
Periprosthetic acetabular fractures in geriatric patients are rare injuries; however, the incidence is increasing because of the current demographic developments. For diagnosis of periprosthetic acetabular fractures, conventional X‑ray images are regularly complemented by computed tomography (CT). For exclusion of loosening of the prosthesis more advanced techniques, such as single photon emission CT (SPECT/CT) are applied. In addition to classification of periprosthetic acetabular fractures by the traditional system of Letournel there are several other classification systems, which take into account the etiology of the fracture and the stability of the prosthesis...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28042115/reconstruction-of-non-contained-acetabular-defects-with-impaction-grafting-a-reinforcement-mesh-and-a-cemented-polyethylene-acetabular-component
#5
B S Waddell, A Gonzalez Della Valle
This review summarises the technique of impaction grafting with mesh augmentation for the treatment of uncontained acetabular defects in revision hip arthroplasty. The ideal acetabular revision should restore bone stock, use a small socket in the near-anatomic position, and provide durable fixation. Impaction bone grafting, which has been in use for over 40 years, offers the ability to achieve these goals in uncontained defects. The precepts of modern, revision impaction grafting are that the segmental or cavitary defects must be supported with a mesh; the contained cavity is filled with vigorously impacted morselised fresh-frozen allograft; and finally, acrylic cement is used to stabilise the graft and provide rigid, long-lasting fixation of the revised acetabular component...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28026721/standard-approaches-to-the-acetabulum-part-2-ilioinguinal-approach
#6
A Gänsslen, S T Grechenig, M Nerlich, M Müller, W Grechenig
The ilioinguinal approach is one of the standard approaches in the treatment of displaced acetabular fractures used during the last decades (9). The meta-analysis of Giannoudis et al. showed that 21.9% of acetabular fractures were historically treated using this approach (3). One of the disadvantages of this study was, that studies focussing especially on posterior wall stabilization and studies dealing with more complex fracture types treated by extended approaches were integrated. Thus, these fracture types were overrepresented...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28025151/normative-3d-acetabular-orientation%C3%A2-measurements-by-the-low-dose-eos-imaging-system-in-102-asymptomatic-subjects-in-standing-position-analyses-by-side-gender-pelvic-incidence-and-reproducibility
#7
Thomas Thelen, Philippe Thelen, Hugues Demezon, Stephane Aunoble, Jean-Charles Le Huec
BACKGROUND: Three-dimensional (3D) acetabular orientation is a fundamental topic in orthopedic surgery. Computed tomography (CT) allows 3D measurement of native acetabular orientation, but with a substantial radiation dose. The EOS imaging system was developed to perform this kind of evaluation, but has not been validated in this indication with specific attention to the acetabulum. We therefore performed a prospective study using EOS to assess: 1) the reproducibility of the 3D acetabulum orientation measures; 2) normative asymptomatic acetabular morphology in standing position, according to side and gender; and 3) the relationship between acetabular anteversion and pelvic incidence...
December 23, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28012061/-treatment-of-acetabular-bone-defects-in-revision-hip-arthroplasty-using-the-revisio-system
#8
M Hoberg, B M Holzapfel, A F Steinert, F Kratzer, M Walcher, M Rudert
BACKGROUND: Many different systems for the management of primary and secondary acetabular defects are available, each with its inherent advantages and disadvantages. The Revisio-System is a press-fit oval mono-block implant that makes a defect-oriented reconstruction and restoration of the center of rotation possible. MATERIAL AND METHODS: In this study, we retrospectively reviewed the outcome of 92 consecutive patients treated with this oval press-fit cup due to periacetabular bone loss...
December 23, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27998657/the-relationship-between-polyethylene-wear-and-periprosthetic-osteolysis-in-total-hip-arthroplasty-at-12-years-in-a-randomized-controlled-trial-cohort
#9
John A J Broomfield, Tamer T Malak, Geraint E R Thomas, Antony J R Palmer, Adrian Taylor, Sion Glyn-Jones
BACKGROUND: Polyethylene acetabular components are common in hip arthroplasty. Highly cross-linked polyethylene (HXLPE) has lower wear than ultra-high molecular weight polyethylene (UHMWPE). Evidence suggests that wear particles induce inflammation causing periprosthetic osteolysis contributing to implant loosening with wear rates of 0.05 mm/y were considered safe. We aimed to compare incidence and volume of periacetabular osteolysis between HXLPE and UHMWPE using computed tomography...
November 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27997468/locking-compression-pilon-plate-for-fixation-of-comminuted-posterior-wall-acetabular-fractures-a-novel-technique
#10
Adam K Lee, Benjamin R Wagner, Kristin McPhillips, Daniel S Horwitz, James C Widmaier
Posterior wall acetabular fractures involving a large portion the wall's width and with extensive comminution are difficult fractures to manage operatively. Cortical substitution with a pelvic reconstruction plate and supplemental spring plates has been the traditional means of fixation for these fractures. This option, however, requires the use of multiple, unlinked plates and provides no reliable option for peripheral fixation in comminuted fragments. We describe a novel technique for operative fixation of large, comminuted posterior wall fractures using a single distal tibia pilon plate with the option for peripheral locking screw fixation and report on a series of 20 consecutive patients treated with this method...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27984686/-surgical-treatment-of-malignant-primary-tumors-of-the-pelvis-on-ennekings-zone-ii
#11
A M González-Pérez, C Arvinius, J García-Coiradas, R García-Maroto, J L Cebrian-Parra
INTRODUCTION: Surgical treatment of malignant bone tumors of the pelvis with periacetabular involvement is constantly evolving. Even though acetabular reconstructions improve quality of life without impairing cancer control, they are not complication free. Our purpose is to describe the functional outcomes and surgical complications of different reconstructive techniques for Enneking zone II tumors. MATERIAL AND METHODS: Fifteen patients underwent surgery for malignant pelvic bone tumors between 2002 and 2012...
May 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27977586/application-of-a-3-dimensional-printed-navigation-template-in-bernese-periacetabular-osteotomies-a-cadaveric-study
#12
You Zhou, Xiaopeng Kang, Chuan Li, Xiaoshan Xu, Rong Li, Jun Wang, Wei Li, Haotian Luo, Sheng Lu
The aim of the present study was to describe the application of 3D printed templates for intraoperative navigation and simulation of periacetabular osteotomies (PAOs) in a cadaveric model.Five cadaveric specimens (10 sides) underwent thin-slice computed tomographic scans of the ala of ilium downwards to the proximal end of femoral shaft. Bernese PAO was performed. Using Mimics v10.1 software (Materialise, Leuven, Belgium), 3D computed tomographic reconstructions were created and the 4 standard PAO bone cuts-ischial, pubic, anterior, and posterior aspects of the ilium-as well as rotation of the dislocated acetabular bone blocks were simulated for each specimen...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27973962/computer-assisted-virtual-preoperative-planning-in-orthopedic-surgery-for-acetabular-fractures-based-on-actual-computed-tomography-data
#13
Guang-Ye Wang, Wen-Jun Huang, Qi Song, Yun-Tian Qin, Jin-Feng Liang
Acetabular fractures have always been very challenging for orthopedic surgeons; therefore, appropriate preoperative evaluation and planning are particularly important. This study aimed to explore the application methods and clinical value of preoperative computer simulation (PCS) in treating pelvic and acetabular fractures. Spiral computed tomography (CT) was performed on 13 patients with pelvic and acetabular fractures, and Digital Imaging and Communications in Medicine (DICOM) data were then input into Mimics software to reconstruct three-dimensional (3D) models of actual pelvic and acetabular fractures for preoperative simulative reduction and fixation, and to simulate each surgical procedure...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27973947/biomechanical-comparison-of-fixation-systems-in-posterior-wall-fracture-of-acetabular-by-finite-element-analysis
#14
Jianyin Lei, Haibo Liu, Zhiqiang Li, Zhihua Wang, Ximing Liu, Longmao Zhao
BACKGROUND: The use of reconstruction plates and lag screws has been recommended for fractures to the posterior wall of the acetabulum. However, little information about the rigidity of recommended forms of fracture fixation is available. This study aimed to evaluate the biomechanical difference among the fixation systems. METHODS: A posterior wall fracture, which is represented by softer elements with lower elastic modulus, was created along an arc of 40-90° about the acetabular rim...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27957883/virtual-anatomical-reconstruction-of-large-acetabular-bone-defects-using-a-statistical-shape-model
#15
Peter Vanden Berghe, Jan Demol, Frederik Gelaude, Jos Vander Sloten
Custom implants are used to treat patients with large acetabular bone defects. To quantify the bone defect and to initialize the implant design, a virtual anatomical reconstruction of the bone needs to be performed. Our SSM-based reconstruction approach was used to overcome the limitations of the mirrored contralateral method and improves upon other SSM reconstruction techniques. The reconstruction errors for the acetabular direction, the hip joint center and the acetabular radius were, respectively: [Formula: see text], 2...
December 13, 2016: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/27923597/long-term-results-of-cementless-total-hip-arthroplasty-with-subtrochanteric-shortening-osteotomy-in-crowe-type-iv-developmental-dysplasia
#16
Duan Wang, Ling-Li Li, Hao-Yang Wang, Fu-Xing Pei, Zong-Ke Zhou
BACKGROUND: When surgeons reconstruct hips with a high dislocation related to severe developmental dysplasia of the hip (DDH) in total hip arthroplasty (THA), archiving long-term stable implant fixation and improving patient function and satisfaction remain challenging. The purpose of this study was to evaluate the 10-year outcomes of transverse subtrochanteric shortening osteotomy in cementless, modular THA in Crowe type IV-Hartofilakidis type III DDH. METHODS: We reviewed 62 patients (76 hips) who underwent cementless THA with transverse subtrochanteric shortening osteotomy from 2002-2010...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27922983/current-construct-options-for-revision-of-large-acetabular-defects-a-systematic-review
#17
Marieke Baauw, Miranda L van Hooff, Maarten Spruit
BACKGROUND: Many treatment options are available for the revision of large acetabular defects. Debate continues as to which technique is most effective. METHODS: A systematic review was performed according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines to evaluate the effectiveness of interventions for large acetabular defects. Quality assessment was performed next with use of 8 items of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for reports of observational studies...
November 8, 2016: JBJS Reviews
https://www.readbyqxmd.com/read/27909669/reconstruction-of-massive-posterior-nonrepairable-acetabular-labral-tears-with-peroneus-brevis-tendon-allograft-arthroscopy-assisted-mini-open-approach
#18
Esther Moya, Luis Gerardo Natera, Carlomagno Cardenas, Emanuele Astarita, Vittorio Bellotti, Manel Ribas
Many of the described labral-reconstruction procedures are purely arthroscopic. This approach only allows segmentary reconstructions. For more extensive reconstructions, surgical dislocation of the hip still represents the more suitable approach. We present an arthroscopy-assisted procedure combined with an anterior mini-open approach, which could be considered for reconstruction of nonrepairable labral lesions located in the posterior aspect of the acetabulum and massive reconstructions in cases of global-pincer femoroacetabular impingement and protrusio acetabuli...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27837399/reconstruction-of-the-shallow-acetabulum-with-a-combination-of-autologous-bulk-and-impaction-bone-grafting-fixed-by-cement
#19
Masaaki Maruyama, Shinji Wakabayashi, Hiroshi Ota, Keiji Tensho
BACKGROUND: Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method). QUESTIONS/PURPOSES: In a population of patients with acetabular dysplasia undergoing THA using a medial-reduced cemented socket and additional bulk bone with impacted morselized bone grafting, we evaluated (1) the radiographic appearance of bone graft; (2) the proportion of cups that developed loosening and subsequent revision; and (3) clinical results (outcome scores and complications)...
November 11, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27800202/leg-lengthening-as-a-means-of-improving-ambulation-following-an-internal-hemipelvectomy
#20
Wakyo Sato, Hiroshi Okazaki, Takahiro Goto
Reconstructive surgery following an internal hemipelvectomy for a malignant pelvic tumor is difficult due to the structural complexity of the pelvis and the massive extension of the tumor. While high complication rates have been encountered in various types of reconstructive surgery, resection without reconstruction reportedly involved fewer complications. However, this method often results in limb shortening with resultant instability during walking. We reported herein leg lengthening performed to correct lower limb shortening after an internal hemipelvectomy, which improved ambulatory stability and overall QOL...
2016: Case Reports in Orthopedics
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