Outcomes and prognostic factors in revision hip arthroplasty for severe intra-pelvic cup protrusion: 246 cases

Epinette, Jean-Alain; Mertl, P.; Combourieu, B.; Gonçalves, Hernâni; Blairon, Alexandre; Ehlinger, Matthieu; Tabutin, J.

doi:10.1016/j.otsr.2015.07.002

Cited by 9 publications

(13 citation statements)

References 18 publications

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“…Current review papers clear ly indicate a downward trend in complications during THA. At the same time, a review by Barbier and a worldwide register analysis by Sa doghi con firm that 15-18% of compli ca tions are due to operator mistakes [2,3,11]. The statistical im provement has been owed, among others, to greater precision of ima ging modalities.…”

Section: Discussionmentioning

confidence: 99%

“…Ak tu al ne prze glą dy pi śmien nic twa jed no znacz nie wska zu ją na bar dzo du ży ich pro cen towy spa dek. Prze gląd pi śmien nic twa Bar bier czy świa -to we re je stry Sa do ghi po twier dza ją jed nak 15-18% udział błę dów ope ra to ra w licz bie po wi kłań [2,3,11]. Na wy ni ki le cze nia wpływ ma ją mię dzy in ny mi coraz pre cy zyj niej sze me to dy ob ra zo wa nia.…”

Section: Dys Ku Sjaunclassified

“…Of major importance for minimizing the risk of complications are: such factors as the availability of modern imaging technology; preoperative planning, including the development of alternative and emergency strategies; and the experience of the surgical team [1]. There are four basic types of intraoperative and early postoperative complications: vascular, neurological, mechanical (mainly intraoperative pro ximal femoral fractures during RHA and THA using cement less prostheses), and mixed vas cu lar-neurolo gical (most common type) [1][2][3][4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Ogromne zna cze nie w mi ni ma li za cji ry zy ka po wi kłań ma ją: współ cze sne mo żli wo ści ob ra zo wa nia, pla no wa nie przed ope ra cyj ne z okre śle niem wa rian tów awa ryjnych oraz do świad cze nie ze spo łu ope ra cyj ne go [1]. W po wi kła niach śród o pe ra cyj nych i po ope ra cyj nych wcze snych, mo żna wy od ręb nić ich 4 pod sta wo we rodza je: na czy nio we, neu ro lo gicz ne, me cha nicz ne najczę ściej śród o pe ra cyj ne zła ma nia w od cin ku bli ższym ko ści udo wej pod czas ope ra cji re wi zyj nych i pierwot nych z za sto so wa niem trzpie nia bez ce men to wego oraz mie sza ne, naj czę ściej na czy nio wo -neu ro lo giczne [1][2][3][4][5][6][7][8][9][10][11]. …”

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Surgical Strategy in Intra-pelvic Cup Migration During Total Hip Arthroplasty. A Case Study

Pozowski¹,

Kowal²,

Kuciel−Lewandowska³

et al. 2016

Ortop Traumatol Rehabil

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STRESZCZENIEPrzed sta wiono przy pa dek 63-let niej pa cjent ki skie ro wa nej do na sze go ośrod ka z po wo du wcze snych po wikłań po ope ra cyj nych bę dą cych wy ni kiem błę du śród o pe ra cyj ne go. Pod czas przy go to wy wa nia ło ży ska dla panew ki en do pro te zy wy ła ma no jej dno, wy twa rza jąc roz le gły uby tek seg men tal ny o śred ni cy uży wa ne go fre zu. Pró ba sta bi li za cji pa new ki en do pro te zy za po mo cą ce men tu kost ne go bez od two rze nia ubyt ku oka za ła się niesku tecz na, a sa mo roz wią za nie bu dzi ło zdzi wie nie. Pod czas osa dza nia pa new ki en do pro te zy na ce men cie kostnym, znacz na je go część zo sta ła we pchnię ta w głąb, po za ob rys pa new ki kost nej. Stop nio wa wcze sna mi gracja pa new ki en do pro te zy wraz z ce men tem, wo bec niepod ję cia szyb kiej in ter wen cji ope ra cyj nej, do pro wa dziła do ich prze miesz cze nia w głąb ja my brzusz nej. Wy nik ba da nia ob ra zo we go wy ko na ne go po 3 mie sią cach od ope ra cji za de cy do wał o przy ję ciu dwu eta po we go po stę po wa nia ope ra cyj ne go. W pierw szym z do stę pu poza otrzew no we go usu nię to ce ment i pa new kę. W dru gim, po 3 ty go dniach, wy ko na no re alo pla sty kę czę ści panew ko wej en do pro te zy z re kon struk cją dna pa new ki.Słowa kluczowe: staw biodrowy, panewka, endoprotezoplastyka, protruzja SUMMARYWe report the case of a 63-year-old female patient referred to our department due to an early postoperative complication resulting from intraoperative fault. During the preparation of a bone socket for the acetabular cup, the acetabular fossa was broken, forming an extensive segmental defect of the diameter of the reamer used. An attempt to stabilize the acetabular prosthesis using bone cement without repairing the bone defect was ineffective and inappropriate. During the deposition of the acetabular prosthesis on the cement, much of the cement was pushed beyond the outline of the bony acetabulum. Progressive early migration of the acetabular cup together with the cement due to the non-implementation of rapid intervention led to their displacement into the abdominal cavity. On analysing a radiograph performed 3 months after the operation, we decided to adopt a two-stage surgical strategy. In the first stage, the acetabular prosthesis with the cement was removed from a retroperitoneal approach. Three weeks later a revision arthroplasty of the acetabular component was carried out with reconstruction of the acetabular floor. Key words: hip, acetabulum, total hip arthroplasty, protrusionO O r r t t o o p p e e d d i i a a Traumatologia Rehabilitacja © MEDSPORTPRESS, 2016; 3(6); Vol. 18, 289-294 DOI: 10.5604/15093492.1212998 WSTĘPBłę dy śród o pe ra cyj ne mo gą zda rzyć się ka żde mu ope ru ją ce mu. Za rów no chi rur gom z mniej szym, jak i z więk szym do świad cze niem. Tym dru gim przy trafić się mo gą ra czej w przy pad kach o du żej ska li trudno ści. O pro ble mach ope ra cyj nych i kom pli ka cjach w ar tro pla sty kach bio dra pier wot nych (THA) i re wizyj nych ...

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Section: Discussionmentioning

confidence: 99%

Section: Dys Ku Sjaunclassified

Section: Introductionmentioning

confidence: 99%

unclassified

See 2 more Smart Citations

Surgical Strategy in Intra-pelvic Cup Migration During Total Hip Arthroplasty. A Case Study

Pozowski¹,

Kowal²,

Kuciel−Lewandowska³

et al. 2016

Ortop Traumatol Rehabil

View full text Add to dashboard Cite

show abstract

“…In a case series of 246 rTHAs by Epinette et al. [2] , 4 cases were complicated by vascular etiologies, of which 2 resulted in fatalities, demonstrating the high risk of mortality in this patient population. Here, we present a case of severe intrapelvic migration of the acetabular component after THA requiring revision.…”

Section: Introductionmentioning

confidence: 92%

Preoperative optimization for vascular involvement complicating revision total hip arthroplasty

et al. 2018

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Vascular complications in revision total hip arthroplasty may occur in cases where the components of the hip implant migrate through the acetabular wall, through the iliopectineal line of the pelvis, and into the pelvic cavity. This migration may lead to substantial intrapelvic vascular compromise, drastically increasing the surgical complexity and potential risk for morbidity and mortality in these surgical cases. Here, we present a case of a 78-year-old woman with significant acetabular protrusio, which resulted in intraoperative compromise of the external iliac artery with rapid extravasation. As a result of prudent preoperative planning, interdisciplinary collaboration, and precautionary measures, significant patient morbidity and mortality was averted.Level of EvidenceLevel V, Case Report.

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Hip malformation is a very common finding in young patients scheduled for total hip arthroplasty

Karimi

Kallemose

Troelsen

et al. 2018

Arch Orthop Trauma Surg

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All patients showed malformations, especially high prevalences were found for CAM-deformity, coxa profunda and acetabular retroversion. Identifying these malformations is fairly simple and recognizing the high prevalence may help surgeons avoid pitfalls during implant positioning in THA surgery. Further, focus on hip malformations may facilitate correct referral to joint-preserving surgery before OA develops.

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Outcomes and prognostic factors in revision hip arthroplasty for severe intra-pelvic cup protrusion: 246 cases

Cited by 9 publications

References 18 publications

Surgical Strategy in Intra-pelvic Cup Migration During Total Hip Arthroplasty. A Case Study

Surgical Strategy in Intra-pelvic Cup Migration During Total Hip Arthroplasty. A Case Study

Preoperative optimization for vascular involvement complicating revision total hip arthroplasty

Hip malformation is a very common finding in young patients scheduled for total hip arthroplasty

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