The Extended Direct Anterior Approach for Column Augmentation in the Deficient Pelvis: A Novel Surgical Technique, and Case Series Report

Spanyer, Jonathon; Beaumont, Christopher M.; Yerasimides, Jonathan

doi:10.1016/j.arth.2016.08.012

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…Our data showed that the EIEF group had similar postoperative vertical and horizontal location of COR compared with the IIEF group, in spite of the higher COR in preoperative radiographies. Spanyer et al previously reported using a buttress augment for successful repairing the anterior column through the direct anterior approach [30], while Ballester et al reported the application of buttress augments in treatment of severe acetabular bone loss [2]. The restoration of COR using EIEF technique is similar to those of buttress augment reported in the literature.…”

Section: Discussionmentioning

confidence: 77%

Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

Tang

Zhou

et al. 2019

Preprint

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KEYWORDSrevision total hip arthroplasty, severe bone defect, porous metal augment, intracavitary iliac extended fixation, extracavitary iliac extended fixation 2 Abstract Background: We proposed a new concept of "iliac extended fixation" in revision total hip arthroplasty (THA) as fixation extending superiorly 2 cm beyond the original acetabular rim with porous metal augments, which was further classified into intracavitary and extracavitary fixation. This study reports the minimum 2 years outcome of the iliac extended fixation technique in patients with Paprosky type 3 acetabular defects.Methods: Thirty two revision THA patients were retrospectively reviewed who underwent reconstruction with the concept of iliac extended fixation from 2014 to 2016 in our hospital. Patients were assessed using the Harris Hip Score (HHS) and the Western Ontario and McMaster UniversitiesOsteoarthritis Index score (WOMAC). In addition, radiographs were assessed and patient reported satisfaction was collected.Results: At an average follow-up of 40 months (range 25 -64 months), the postoperative HHS and WOMAC scores were significantly improved at the last follow-up (p < 0.001). The postoperative horizontal and vertical locations of the COR were significantly improved from the preoperative measurements (p < 0.05). Two (6.3 %) patients were dissatisfied with the outcome. The extracavitary iliac extended fixation group had significantly more horizontal screws fixation (4.6 ± 25.7° vs 41.9 ± 37.8°, p < 0.001) and higher rate of osteointegration in zone 1A (91.7% vs 50.0%, p = 0.023) than the intracavitary iliac extended fixation group.Conclusions: Intracavitary and extracavitary iliac extended fixation with porous metal augments and cementless cups are effective in reconstructing severe superior acetabular bone defects, with promising short-term clinical and radiographic outcome.

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Section: Discussionmentioning

confidence: 77%

Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

Tang

Zhou

et al. 2019

Preprint

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“…The first is the selection of a surgical approach. As the direct anterior approach has become an increasingly popular, minimally invasive technique because of decreased pain and accelerated functional recovery, it has become more commonly selected by surgeons for performing total hip arthroplasty in recent years [28]. However, even though three patients underwent surgery via the anterior approach in our study, we do not recommend this technique for these special cases.…”

Section: Surgical Treatmentmentioning

confidence: 79%

Diagnosis, Preoperative Evaluation, Classification and Total Hip Arthroplasty in Patients with Long-Term Unreduced Hip Joint Dislocation, Secondary Osteoarthritis and Pseudoarthrosis

Liu

Zhuang

et al. 2020

Preprint

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Background Neglected long-term unreduced hip joint dislocation with secondary osteoarthritis and pseudoarthrosis poses a great challenge to hip surgeons. However, as this is an uncommon injury, few studies have systematically investigated these patients.Methods We retrospectively reviewed 16 patients from 2010 to 2017. The diagnostic value of three different kinds of common radiological examinations were evaluated. We evaluated the bone conditions of the original acetabulum and classified the patients into three types (four subtypes). The surgical procedures and prognosis of the patients were also investigated.Results With the combined application of X-ray, CT scans and 3D reconstruction, 93.8% of these patients (sensitivity = 93.8%, Youden’s index = 0.93, intraclass correlation coefficient = 0.95) could be diagnosed correctly. There were 6/16 (37.5%) type A patients, 4/16 (25.0%) type B1 patients, 5/16 (31.3%) type B2 patients and 1/16 (6.3%) type C patient. For patients with type A injury, the surgical procedures for total hip arthroplasty were similar to “standard” total hip arthroplasty. For patients with type B injury, due to atrophy or partial bone deficiency of the original acetabulum, the surgical procedure for total hip arthroplasty was probably similar to those for patients with developmental dysplasia of the hip. For patients with type C injury, the situation was similar to that of revision surgery. The average Harris hip score postoperatively was 89.94 ± 5.78 points (range: 79–98 points).Conclusions The new classification system could help surgeons estimate potential difficulties during total hip arthroplasty. The prognosis of most patients after total hip arthroplasty is expected to be excellent or good.

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“…The first is the selection of a surgical approach. As the direct anterior approach has become an increasingly popular, minimally invasive technique because of decreased pain and accelerated functional recovery, it has become more commonly selected by surgeons for performing total hip arthroplasty in recent years [32]. However, even though three patients underwent surgery via the anterior approach in our study, we do not recommend this technique for these special cases.…”

Section: Surgical Treatmentmentioning

confidence: 79%

Diagnosis, preoperative evaluation, classification and total hip arthroplasty in patients with long-term unreduced hip joint dislocation, secondary osteoarthritis and pseudoarthrosis

Liu

Zhuang

et al. 2020

BMC Musculoskelet Disord

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Background Neglected long-term unreduced hip joint dislocation with secondary osteoarthritis and pseudoarthrosis poses a great challenge to hip surgeons. However, as this is an uncommon injury, few studies have systematically investigated these patients. Methods We retrospectively reviewed 16 patients from 2010 to 2017. The diagnostic values of three different types of common radiological examinations were evaluated. We evaluated the bone conditions of the original acetabulum and classified the patients into three types (four subtypes). The surgical procedures and prognosis of the patients were also investigated. Results With the combined application of X-ray, CT scans and 3D reconstruction, 93.8% of these patients (sensitivity = 93.8%, Youden’s index = 0.93, intraclass correlation coefficient = 0.95) could be diagnosed correctly. There were 6/16 (37.5%) type A patients, 4/16 (25.0%) type B1 patients, 5/16 (31.3%) type B2 patients and 1/16 (6.3%) type C patient. For patients with type A injury, the surgical procedures for total hip arthroplasty were similar to “standard” total hip arthroplasty. For patients with type B injury, due to atrophy or partial bone deficiency of the original acetabulum, the surgical procedure for total hip arthroplasty was probably similar to those for patients with developmental dysplasia of the hip. For patients with type C injury, the situation was similar to that of revision surgery. The average Harris hip score postoperatively was 89.94 ± 5.78 points (range: 79–98 points). Conclusions The new classification system could help surgeons estimate potential difficulties during total hip arthroplasty. The prognosis of most patients after total hip arthroplasty is expected to be excellent or good.

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The Extended Direct Anterior Approach for Column Augmentation in the Deficient Pelvis: A Novel Surgical Technique, and Case Series Report

Cited by 16 publications

References 15 publications

Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

Diagnosis, Preoperative Evaluation, Classification and Total Hip Arthroplasty in Patients with Long-Term Unreduced Hip Joint Dislocation, Secondary Osteoarthritis and Pseudoarthrosis

Diagnosis, preoperative evaluation, classification and total hip arthroplasty in patients with long-term unreduced hip joint dislocation, secondary osteoarthritis and pseudoarthrosis

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