- Discussion:
- Acetabular Component Menu:
- crowe classification: (paprosky classification)
- THR for DDH
- bone grafting for THR:
- protrusio deformity in THR
- cotyloplasty technique: by Hartofilakidis G, et al. (1996)
- technique creates a controlled comminuted fracture of the medial wall which allows for medialization of the cup;
- acetabulum is reamed w/ small reamers;
- rearmers are direted postero-superiorly to avoid the thin anterior column;
- reaming progresses until the outer surface of the inner wall is reached;
- using osteotomes, create a controlled fracture of the thin medial wall, but care is taken not to perforate the inner layer of periosteum;
- autogenous cancellous graft is then sandwhiched against the medial wall;
- the bone graft and medial acetabular wall are then pushed inward;
- the acetabular component is then cemented into place;
- ref: Treatment of high dislocation of the hip in adults with total hip arthroplasty. Operative technique and long-term clinical results.
Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty.
- medial protrusio technique:
- medial wall of a dysplastic acetabulum is intentionally perforated to allow coverage of the acetabular component without bone-graft support;
- results in placement of the medial aspect of the dome of the acetabular component medial to the Kohler line;
- supplemental bone graft is an option;
- multiholed revision cup for posterior superior and inferior screws for maximal support;
- references:
- Acetabular Cup Revision With the Use of the Medial Protrusio Technique at an Average Follow-up of 6.6 Years.
- Medial protrusio technique for placement of a porous-coated, hemispherical acetabular component without cement in a total hip arthroplasty in patients who have acetabular dysplasia.
- Total hip reconstruction in chronically dislocated hips.
- Total hip arthroplasty in chronically dislocated hips. Follow-up study on the protrusio socket technique.
- Acetabular medial wall displacement osteotomy in total hip arthroplasty: a technique to optimize the acetabular reconstruction in acetabular dysplasia.
- Cotyloplasty in cementless total hip arthroplasty for an insufficient acetabulum.
- Cementless total hip arthroplasty with medial wall osteotomy for the sequelae of septic arthritis of the hip.
- Circumferential osteotomy of the medial acetabular wall in total hip replacement for the late sequelae of childhood septic arthritis of the hip.
- [Total hip replacement for the treatment of Crowe IV congenital hip dislocation using small acetabular components combined with medial protrusio technique].
- Evaluation of two surgical techniques for acetabular reconstruction in total hip replacement for congenital hip disease: results after a minimum ten-year follow-up.
- Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty.
- Bone grafting in total hip arthroplasty for insufficient acetabulum
- Low friction arthroplasty for old untreated congenital dislocation of the hip.