Acetabular revision using a trabecular metal acetabular component for severe acetabular bone loss associated with a pelvic discontinuity.

Abstract

Pelvic discontinuity can be encountered during acetabular revision in patients with severe bone loss. All patients who had an acetabular reconstruction for a type IIIB acetabular defect according to the classification of Paprosky et al [Paprosky WG, Perona PG, Lawrence JM. 1994. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty 9:33.] with an associated pelvic discontinuity between 2001 and 2003 were reviewed. A trabecular metal acetabular component with or that without an acetabular augment was used to obtain fixation proximal and distal to the discontinuity. Thirteen patients (13 hips) were treated for a type IIIB acetabular defect. At an average of 2.6 years of follow-up, 1 patient demonstrated possible radiographic loosening. The other 12 patients maintained radiographically stable hips. None of the patients required repeat surgical intervention. Clinically, the patients' modified Postel-Merle d'Aubigne score improved from 6.1 preoperatively to 10.3 postoperatively. The treatment of pelvic discontinuity during acetabular revision using a trabecular metal acetabular component with or that without an associated trabecular metal augment appears to provide reliable and reproducible short-term results.