RSA Measurements of Implant Instability in a Paprosky III Pelvic Defect with Discontinuity

Ramasamy, Boopalan; Abrahams, John M.; Clothier, Robyn; Solomon, Lucian B.; Callary, Stuart A.

doi:10.2106/jbjs.cc.22.00296

JBJS Case Connector

2022

DOI: 10.2106/jbjs.cc.22.00296

|View full text |Cite

RSA Measurements of Implant Instability in a Paprosky III Pelvic Defect with Discontinuity

Boopalan Ramasamy

John M. Abrahams

Robyn Clothier

et al.

Abstract: Case: We report a case of acetabular reconstruction for a large defect with pelvic discontinuity that underwent 4 revisions for dislocations over a 3-year period. This allowed assessment of implant stability both on imaging, using measurements on plain radiographs and radiostereometric analysis (RSA) against both ilium and ischium, and direct assessment during each surgery. Only implant stability measured with RSA correlated with intraoperative revision findings. Conclusion:This case underlines the role of RSA… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2024

Publication Types

Select...

Article1

Relationship

Self Cite0

Independent1

Authors

Journals

Cited by 1 publication

References 24 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

Virtual biomechanical assessment of porous tantalum and custom triflange components in the treatment of patients with acetabular defects and pelvic discontinuity

Callary,

Broekhuis,

Barends

et al. 2024

Bone Joint J

View full text Add to dashboard Cite

AimsThe aim of this study was to compare the biomechanical models of two frequently used techniques for reconstructing severe acetabular defects with pelvic discontinuity in revision total hip arthroplasty (THA) – the Trabecular Metal Acetabular Revision System (TMARS) and custom triflange acetabular components (CTACs) – using virtual modelling.MethodsPre- and postoperative CT scans from ten patients who underwent revision with the TMARS for a Paprosky IIIB acetabular defect with pelvic discontinuity were retrospectively collated. Computer models of a CTAC implant were designed from the preoperative CT scans of these patients. Computer models of the TMARS reconstruction were segmented from postoperative CT scans using a semi-automated method. The amount of bone removed, the implant-bone apposition that was achieved, and the restoration of the centre of rotation of the hip were compared between all the actual TMARS and the virtual CTAC implants.ResultsThe median amount of bone removed for TMARS reconstructions was significantly greater than for CTAC implants (9.07 cm3 (interquartile range (IQR) 5.86 to 21.42) vs 1.16 cm3 (IQR 0.42 to 3.53) (p = 0.004). There was no significant difference between the median overall implant-bone apposition between TMARS reconstructions and CTAC implants (54.8 cm2 (IQR 28.2 to 82.3) vs 56.6 cm2 (IQR 40.6 to 69.7) (p = 0.683). However, there was significantly more implant-bone apposition within the residual acetabulum (45.2 cm2 (IQR 28.2 to 72.4) vs 25.5 cm2 (IQR 12.8 to 44.1) (p = 0.001) and conversely significantly less apposition with the outer cortex of the pelvis for TMARS implants compared with CTAC reconstructions (0 cm2 (IQR 0 to 13.1) vs 23.2 cm2 (IQR 16.4 to 30.6) (p = 0.009). The mean centre of rotation of the hip of TMARS reconstructions differed by a mean of 11.1 mm (3 to 28) compared with CTAC implants.ConclusionIn using TMARS, more bone is removed, thus achieving more implant-bone apposition within the residual acetabular bone. In CTAC implants, the amount of bone removed is minimal, while the implant-bone apposition is more evenly distributed between the residual acetabulum and the outer cortex of the pelvis. The differences suggest that these implants used to treat pelvic discontinuity might achieve short- and long-term stability through different biomechanical mechanisms.Cite this article: Bone Joint J 2024;106-B(5 Supple B):74–81.

show abstract

Virtual biomechanical assessment of porous tantalum and custom triflange components in the treatment of patients with acetabular defects and pelvic discontinuity

Callary,

Broekhuis,

Barends

et al. 2024

Bone Joint J

View full text Add to dashboard Cite

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

RSA Measurements of Implant Instability in a Paprosky III Pelvic Defect with Discontinuity

Cited by 1 publication

References 24 publications

Virtual biomechanical assessment of porous tantalum and custom triflange components in the treatment of patients with acetabular defects and pelvic discontinuity

Virtual biomechanical assessment of porous tantalum and custom triflange components in the treatment of patients with acetabular defects and pelvic discontinuity

Contact Info

Product

Resources

About