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Trabecular Metal in Acetabular Revision Surgery for Severe Bone Defects and Pelvic Discontinuity

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Acetabular Revision Surgery in Major Bone Defects

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Abstract

The treatment of acetabular revisions with major bone defects and pelvic discontinuity is controversial. In young people, we are advocates of restoring bone stock and will therefore recommend the use of the impaction grafting technique, taking care to strengthen the assembly of posterolateral defects with tantalum augments (hybrid technique).

An alternative to this technique for younger patients would be implantation a reinforcement ring with a structural or fragmented graft. For older patients, our first option is to use the benefits of the trabecular metal system and cup-cage construct and fragmented graft. For chronic pelvic discontinuities (PD), we follow the philosophy of distraction and Cup-Cage construct. In weakened pelvis (bilateral PD, periacetabular tumor post-resection, irradiated, etc.), we reinforced it with one or two plates in the posterior column. In very irregular and catastrophic lesions with PD, and where we have doubts about their possible solution with TM system, the use of the custom-made triflange cup may be indicated, which is increasingly presented as a more reliable and cost-effective technique, but not without complications.

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Authors and Affiliations

  1. Orthopaedics Department, Medical School, Cadiz University, Cadiz, Spain

    José Sueiro-Fernandez

  2. Orthopaedic Surgery Department, Hospital Puerto Real, Cadiz, Spain

    José Sueiro-Fernandez

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  1. José Sueiro-Fernandez
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Correspondence to José Sueiro-Fernandez .

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  1. Orthopaedic Surgery Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain

    Eduardo García-Rey

  2. Orthopaedic Surgery Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain

    Eduardo García-Cimbrelo

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Sueiro-Fernandez, J. (2019). Trabecular Metal in Acetabular Revision Surgery for Severe Bone Defects and Pelvic Discontinuity. In: García-Rey, E., García-Cimbrelo, E. (eds) Acetabular Revision Surgery in Major Bone Defects. Springer, Cham. https://doi.org/10.1007/978-3-319-98596-1_11

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  • DOI: https://doi.org/10.1007/978-3-319-98596-1_11

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