Characterizing acetabular defects and need of major reconstruction during total hip arthroplasty in patients with acetabular protrusion- a retrospective study

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-01-12 DOI:10.1016/j.jcot.2024.102847

Rajesh Malhotra , Deepak Gautam , Jaiben George

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Abstract

Purpose

Total hip arthroplasty (THA) in patients with acetabular protrusion can be challenging due to the lack of acetabular bone support. Some patients may require a major reconstructive procedure to aid in the fixation of the acetabular components. The purpose of the study was to characterize the type of acetabular defects in patients with protrusion and to assess the need for major reconstruction.

Methods

This was a retrospective study of 125 THAs performed at a single tertiary center from 2010 to 2020 by a single surgeon in patients with acetabular protrusion. Demographics, operative details and radiographic details were recorded. THAs in which a structural graft, cage or augment were used for acetabular reconstruction were considered to have undergone a major reconstructive procedure and a classification system was proposed to identify patients requiring major reconstruction.

Results

10 (8 %) THAs required a major reconstruction in our cohort (2- augment, 8- structural allograft. There was significant difference in acetabular defects based on the etiology. Major reconstruction was more common when the diagnosis was sequalae of tuberculosis or post-traumatic arthritis. Simple cavitatory defects seldom required a major reconstruction while combined defects and medial wall deficiency increased the risk of requiring a major reconstruction.

Conclusion

The severity of defects varied considerably with majority of patients having cavitatory type of defect which can be successfully managed without the need of any major reconstructive measures. A simple classification based on the type of defect and medial wall competency appeared to be useful in identifying patients who may need a major reconstructive procedure during THA.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.