Revision ArthroplastyPreoperative Radiographic Evaluation of Patients With Pelvic Discontinuity
Section snippets
Materials and Methods
Study approval was obtained by our institution’s review board. The total joint registry at our institution was used to identify all total hip arthroplasty revision cases in patients aged older than 18 years that were performed for PD from 1997 to 2011. A specific code identified the medical record numbers for all patients who had intraoperatively identified PD. Each patient’s medical record was retrieved, and the operative report was reviewed to confirm PD was present at the time of revision
Results
We identified 133 hips with intraoperatively confirmed PD. All hips had at least an AP pelvis radiograph that was obtained preoperatively. Additional views included a true lateral hip radiograph in 132 hips, Judet views in 47 hips, false profile views in 4 hips, and 14 had a preoperative CT scan.
The patient cohort included 21 male patients and 112 females. The modified AAOS [2] classification consisted of 4 patients with type IVA, 126 patients with type IVB, and 3 patients with type IVC
Discussion
PD remains a difficult reconstructive problem [6]. The challenges include gaining stable acetabular component fixation in the presence of a PD and achieving healing of the pelvis in the presence of bone loss. Special complex reconstructive methods typically are needed for successful management; therefore, it is desirable to identify patients with PD before surgery.
PD may be difficult to detect on radiographs for several reasons. Frequently metal (either an acetabular component or internal
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Cited by (10)
Advanced quantitative 3D imaging improves the reliability of the classification of acetabular defects
2023, Archives of Orthopaedic and Trauma SurgeryPelvic discontinuity: a challenge to overcome
2021, EFORT Open ReviewsAcetabular defects in revision hip arthroplasty: a therapy-oriented classification
2020, Archives of Orthopaedic and Trauma SurgeryEvaluation and management of chronic pelvic discontinuity in revision total hip arthroplasty
2020, Chinese Journal of Orthopaedics
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2015.11.024.