Treatment for pelvic discontinuity due to acetabular fracture by means of hip arthroplasty revision surgery and acetabular component replacement using a Burch-Schneider ring: a case report
DOI:
https://doi.org/10.58814/01208845.15Keywords:
Arthroplasty, Hip, Replacement, Revision Surgery, Acetabulum, Hip InjuriesAbstract
Introduction: Pelvic discontinuity is a complication of total hip arthroplasty, consisting of a structural bone defect of the acetabulum with separation of the upper and lower hemipelvis.
Case presentation: A 74-year-old male patient with a history of total left hip arthroplasty and 4 arthroplasty revision surgeries visited the emergency department of a secondary care hospital due to pain and limited mobility of the left hip over a period of 7 days after having suffered a fall from his own height in which the left lower limb received the force of the impact. Physical examination showed limitation of the range of motion of the left hip, so a hip X-ray was performed, showing a fracture of the acetabulum. A computed tomography of the hip revealed signs of loosening of the acetabular component and fracture of the acetabulum (type IIIB according to the Paprosky classification). In view of the above, pelvic discontinuity was diagnosed and revision arthroplasty and replacement of the acetabular component with a Burch-Schneider ring was performed. The patient had an adequate postoperative progression and follow-up at 3 months.
Conclusion: Although there are multiple options for the treatment of pelvic discontinuity, currently, there is no conclusive data regarding the best therapeutic option. However, the use of reinforcement acetabular components, such as the Burch-Schneider ring, was an option with good postoperative outcomes in this case.
Downloads
References
Abdelnasser MK, Klenke FM, Whitlock P, Khalil AM, Khalifa YE, Ali HM, et al. Management of pelvic discontinuity in revision total hip arthroplasty: a review of the literature. Hip Int. 2015;25(2):120-6. https://doi.org/f7d5bj.
Abdel MP, Trousdale RT, Berry DJ. Pelvic discontinuity associated with total hip arthroplasty: Evaluation and management. J Am Acad Orthop Surg. 2017;25(5):330-8. https://doi.org/mbfj.
Babis GC, Nikolaou VS. Pelvic discontinuity: a challenge to overcome. EFORT Open Rev. 2021;6(6):459-71. https://doi.org/mbfk.
Kim YH. Acetabular Cup Revision. Hip Pelvis. 2017;29(3):155-8. https://doi.org/mbfm.
Hasenauer MD, Paprosky WG, Sheth NP. Treatment options for chronic pelvic discontinuity. J Clin Orthop Trauma. 2018;9(1):58-62. https://doi.org/mbfn.
Perticarini L, Rossi SMP, Medetti M, Benazzo F. Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects. J Orthop Traumatol. 2021;22(1):9. https://doi.org/mbfp.
Kmieć K, Dorman T, Andrzej G, Synder M, Kozłowski P, Sibiński M. Early results of revision acetabular cup using antiprotrusio reconstruction rings and allografts. Indian J Orthop. Indian J Orthop. 2015;49(3):317-22. https://doi.org/mbfq.
Philippe R, Gosselin O, Sedaghatian J, Dezaly C, Roche O, Sirveaux F, et al. Acetabular reconstruction using morselized allograft and a reinforcement ring for revision arthroplasty with Paprosky type II and III bone loss: survival analysis of 95 hips after 5 to 13 years. Orthop Traumatol Surg Res. 2012;98(2):129-37. https://doi.org/mbfr.
Volpin A, Konan S, Biz C, Tansey RJ, Haddad FS. Reconstruction of failed acetabular component in the presence of severe acetabular bone loss: a systematic review. Musculoskelet Surg. 2019;103(1):1-13. https://doi.org/mbfs.
Baauw M, Van Hooff ML, Spruit M. Current construct options for revision of large acetabular defects: A systematic review. JBJS Rev. 2016;4(11):e2. https://doi.org/mbft.
Gibon E, Kerboull L, Courpied JP, Hamadouche M. Acetabular reinforcement rings associated with allograft for severe acetabular defects. Int Orthop. 2019;43(3):561-71. https://doi.org/mbfv.
Hsu CC, Hsu CH, Yen SH, Wang JW. Use of the Burch-Schneider cage and structural allografts in complex acetabular deficiency: 3- to 10-year follow up. Kaohsiung J Med Sci. 2015;31(10):540-7. https://doi.org/mbfw.
Beckmann NA, Weiss S, Klotz MCM, Gondan M, Jaeger S, Bitsch RG. Loosening after acetabular revision: Comparison of trabecular metal and reinforcement rings. A systematic review. J Arthroplasty. 2014;29(1):229-35. https://doi.org/mbfx.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Revista Colombiana de ortopedia y traumatología
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
Derechos de autor
Los autores aceptar transferir a la Revista Colombiana de Ortopedia y Traumatología los derechos edición, publicación y reproducción de los artículos publicados. La editorial tiene el derecho del uso, reproducción, transmisión, distribución y publicación en cualquier forma o medio. Los autores no podrán permitir o autorizar el uso de la contribución sin el consentimiento escrito de la revista. Una vez firmada por todos los autores, la carta de Cesión de derechos debe ser cargada en el paso dos del envío.
Aquellos autores que tengan publicaciones en esta revista aceptan los siguientes términos:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web), lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
