Reverse reaming distraction for acetabular reconstruction of chronic pelvic discontinuity

Abstract

Background: The acetabular distraction technique demonstrates encouraging radiographic and clinical outcomes in treating chronic pelvic discontinuity. The aim of this study is to describe a modified distraction technique and to show our results. Methods: This study identified 12 cases of chronic pelvic discontinuity undergoing primary or revision total hip arthroplasty (THA) with the technique of reverse reaming distraction between July 2015 and November 2018. All 12 patients had a minimum follow-up of 12 months. Radiographs were reviewed to inspect for component loosening. Clinical assessment included the Harris hip score (HHS) and an ambulatory scoring system. Results: At the time of final follow-up, no patient was revised. One patient had up to 1 cm migration of the cup in a horizontal or vertical direction and more than 20°change in the abduction angle but was asymptomatic. In the remaining 11 patients, no migration of the component was detected. Both the HHS and ambulatory score showed improvement in all patients. There were no perioperative complications. No postoperative dislocation occurred. Conclusions: Reverse reaming distraction is a feasible technique in treatment of chronic pelvic discontinuity, with encouraging results at early term. However, ongoing follow-up is required to determine the long-term prognosis in patients receiving this technique.

Acetabular Peri-Prosthetic Fractures—A Narrative Review

“…Although relatively new, acetabular distraction is a promising treatment for chronic PD. Excellent results [ 40 , 42 , 53 , 55 ], with low complication rates, 3–5% aseptic loosening [ 40 , 53 ], have been reported at 2- to 7-year follow-up. Custom-made triflange implants are another option to address chronic PD with severe bone loss.…”