Acetabular defects in revision hip arthroplasty: a therapy-oriented classification.
Acetabulum
Arthroplasty
Classification
Hip
Paprosky
Revision
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
12
11
2019
pubmed:
27
2
2020
medline:
10
10
2020
entrez:
27
2
2020
Statut:
ppublish
Résumé
The treatment of severe acetabular bone loss remains a difficult challenge. No classification system is available that combines intuitive use, structured design and offers a therapeutic recommendation according to the current literature and modern state of the art treatment options. The goal of this study is to introduce an intuitive, reproducible and reliable guideline for the evaluation and treatment of acetabular defects. The proposed Acetabular Defect Classification (ADC) is based on the integrity of the acetabular rim and supporting structures. It consists of 4 main types of defects ascending in severity and subdivisions narrowing down-defect location. Type 1 presents an intact acetabular rim, type 2 includes a noncontained defect of the acetabular rim ≤ 10 mm, in type 3 the rim defect exceeds 10 mm and type 4 includes different kinds of pelvic discontinuity. A collective of 207 preoperative radiographs were graded according to ADC and correlated with intraoperative findings. Additionally, a randomized sample of 80 patients was graded according to ADC by 5 observers to account for inter- and intra-rater reliability. We evaluated the agreement of preoperative, radiographic grading and intraoperative findings presenting with a k value of 0.74. Interobserver agreement presented with a k value of 0.62 and intraobserver at a k value of 0.78. The ADC offers an intuitive, reliable and reproducible classification system. It guides the surgeon pre- and intraoperatively through a complex field of practice.
Identifiants
pubmed: 32100108
doi: 10.1007/s00402-020-03379-6
pii: 10.1007/s00402-020-03379-6
pmc: PMC7244606
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
815-825Références
Lübbeke A, Silman AJ, Barea C et al (2018) Mapping existing hip and knee replacement registries in Europe. J Health Pol 122:548–557. https://doi.org/10.1016/j.healthpol.2018.03.010
doi: 10.1016/j.healthpol.2018.03.010
Labek G, Thaler M, Janda W et al (2011) Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Jt Surg Br 93:293–297. https://doi.org/10.1302/0301-620X.93B3.25467
doi: 10.1302/0301-620X.93B3.25467
Gravius S, Pagenstert G, Weber O et al (2009) Acetabular defect reconstruction in revision surgery of the hip. Orthopade 38:729–740. https://doi.org/10.1007/s00132-009-1428-4
doi: 10.1007/s00132-009-1428-4
pubmed: 19672576
Koob S, Scheidt S, Randau TM et al (2017) Biologisches downsizing. Orthopade 6:1–9. https://doi.org/10.1007/s00132-016-3379-x
doi: 10.1007/s00132-016-3379-x
Yu R, Hofstaetter JG, Sullivan T et al (2013) Validity and reliability of the paprosky acetabular defect classification. Clin Orthop Relat Res 471:2259–2265. https://doi.org/10.1007/s11999-013-2844-7
doi: 10.1007/s11999-013-2844-7
pubmed: 23412731
pmcid: 3676616
Landis RJ, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
doi: 10.2307/2529310
Claus AM, Engh CA, Sychterz CJ et al (2003) Radiographic definition of pelvic osteolysis following total hip arthroplasty. J Bone Jt Surg Am 85-A:1519–1526
doi: 10.2106/00004623-200308000-00013
Arnholdt J, Steinert AF, Hoberg M et al (2017) Acetabular defect classification in times of 3D imaging and patient- specific treatment protocols. Orthopade 46:1–11. https://doi.org/10.1007/s00132-016-3378-y
doi: 10.1007/s00132-016-3378-y
Zimlich RH, Fehring TK (2000) Underestimation of pelvic osteolysis: The value of the iliac oblique radiograph. J Arthroplasty 15:796–801. https://doi.org/10.1054/arth.2000.4330
doi: 10.1054/arth.2000.4330
pubmed: 11021458
Martin RJ, Barrett I, Sierra RJ et al (2016) Preoperative radiographic evaluation of patients with pelvic discontinuity. J Arthroplasty 31:1053–1056. https://doi.org/10.1016/j.arth.2015.11.024
doi: 10.1016/j.arth.2015.11.024
pubmed: 26775839
Campbell DG, Garbuz DS, Masri BA, Duncan CP (2001) Reliability of acetabular bone defect classification systems in revision total hip arthroplasty. J Arthroplasty 16:83–86. https://doi.org/10.1054/arth.2001.19157
doi: 10.1054/arth.2001.19157
pubmed: 11172275
Paprosky WG, Perona PG, Lawrence JM (1994) Acetabular defect classification and surgical reconstruction in revision arthroplasty a 6-year follow-up evaluation. J Arthroplasty 9(1):33–44. https://doi.org/10.1016/0883-5403(94)90135-x
doi: 10.1016/0883-5403(94)90135-x
pubmed: 8163974
Lang JE, Bono JV, Smith EL et al (2010) Stability of Revision acetabular components using the rim-fit technique. J Arthroplasty 25:128–132. https://doi.org/10.1016/j.arth.2008.09.013
doi: 10.1016/j.arth.2008.09.013
pubmed: 19056229
Gerhardt DMJM, de Visser E, Hendrickx BW et al (2018) Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery. Acta Orthop 89:302–307. https://doi.org/10.1080/17453674.2018.1460776
doi: 10.1080/17453674.2018.1460776
pubmed: 29635970
pmcid: 6055772
Zuh S-G, Zazgyva A, Gergely I, Pop TS (2015) Acetabuloplasty with bone grafting in uncemented hip replacement for protrusion. Int Orthop 39:1757–1763. https://doi.org/10.1007/s00264-015-2804-9
doi: 10.1007/s00264-015-2804-9
pubmed: 26021269
Schatzker J, Wong MK (1999) Acetabular revision: the role of rings and cages. Clin Orthop Relat Res 369:187
doi: 10.1097/00003086-199912000-00020
Gill TJ, Sledge JB, Müller ME (1998) The Bürch-Schneider anti-protrusio cage in revision total hip arthroplasty. J Bone Jt Surg Br 80-B:946–953
doi: 10.1302/0301-620X.80B6.0800946
Hansen E, Ries MD (2006) Revision total hip arthroplasty for large medial (Protrusio) defects with a rim-fit cementless acetabular component. J Arthroplasty 21:72–79. https://doi.org/10.1016/j.arth.2005.01.022
doi: 10.1016/j.arth.2005.01.022
pubmed: 16446188
Delimar D, Aljinovic A, Bicanic G (2014) Failure of bulk bone grafts after total hip arthroplasty for hip dysplasia. Arch Orthop Trauma Surg 134:1167–1173. https://doi.org/10.1007/s00402-014-2006-8
doi: 10.1007/s00402-014-2006-8
pubmed: 24840037
Kwong LM, Jasty M, Harris WH (1993) High failure rate of bulk femoral head allografts in total hip acetabular reconstructions at 10 years. J Arthroplasty 8(4):341–346
doi: 10.1016/S0883-5403(06)80032-X
Mulroy RD, Harris WH (1998) Failure of acetabular autogenous grafts in total hip arthroplasty. Increasing incidence: a follow-up note. J Bone Jt Surg Am 72:1536–1540
doi: 10.2106/00004623-199072100-00017
Hooten JP, Engh CA, Heekin RD et al (1996) Structural Bulk Allografts in Acetabular Reconstruction. J Bone Jt Surg Br 78-B:270–275. https://doi.org/10.1302/0301-620X.78B2.0780270
doi: 10.1302/0301-620X.78B2.0780270
Roessler PP, Jaenisch M, Kuhlmann M et al (2018) The augment-and-modular-cage revision system for reconstruction of severe acetabular defects-two-year clinical and radiographic results. Int Orthop. https://doi.org/10.1007/s00264-018-4271-6
doi: 10.1007/s00264-018-4271-6
pubmed: 30539219
Friedrich MJ, Gravius S, Schmolders J et al (2014) Biological acetabular defect reconstruction in revision hip arthroplasty using impaction bone grafting and an acetabular reconstruction ring. Oper Orthop Traumatol 26:126–140. https://doi.org/10.1007/s00064-013-0270-3
doi: 10.1007/s00064-013-0270-3
pubmed: 24691908
Villanueva M, Rios-Luna A, Pereiro De Lamo J et al (2008) A review of the treatment of pelvic discontinuity. HSS Jrnl 4:128–137. https://doi.org/10.1007/s11420-008-9075-6
doi: 10.1007/s11420-008-9075-6
Rogers BA, Whittingham-Jones PM, Mitchell PA et al (2012) The reconstruction of periprosthetic pelvic discontinuity. J Arthroplasty 27:1499–1506.e1. https://doi.org/10.1016/j.arth.2011.12.017
doi: 10.1016/j.arth.2011.12.017
pubmed: 22325964
Rudert M, Holzapfel BM, Kratzer F et al (2010) Das Kranialpfannensystem zur defekttypassoziierten Therapie von Azetabulumdefekten. Oper Orthop Traumatol 22:241–255. https://doi.org/10.1007/s00064-010-9003-z
doi: 10.1007/s00064-010-9003-z
pubmed: 20676819
Ghanem M, Zajonz D, Nuwayhid R et al (2019) Management of pelvic discontinuity in revision arthroplasty. Orthopade 48(5):413–419. https://doi.org/10.1007/s00132-018-03675-5
doi: 10.1007/s00132-018-03675-5
pubmed: 30680468
Friedrich MJ, Schmolders J, Michel RD et al (2014) Management of severe periacetabular bone loss combined with pelvic discontinuity in revision hip arthroplasty. Int Orthop 38:2455–2461. https://doi.org/10.1007/s00264-014-2443-6
doi: 10.1007/s00264-014-2443-6
pubmed: 25027976
Berend ME, Berend KR, Lombardi AV et al (2018) The patient-specific Triflange acetabular implant for revision total hip arthroplasty in patients with severe acetabular defects: planning, implantation, and results. Bone Jt J 100-B:50–54. https://doi.org/10.1302/0301-620X.100B1.BJJ-2017-0362.R1
doi: 10.1302/0301-620X.100B1.BJJ-2017-0362.R1
Wyatt MC (2015) Custom 3D-printed acetabular implants in hip surgery-innovative breakthrough or expensive bespoke upgrade? Hip Int 25(4):375–379. https://doi.org/10.5301/hipint.5000294
doi: 10.5301/hipint.5000294
pubmed: 26351112
Li H, Qu X, Mao Y et al (2016) Custom acetabular cages offer stable fixation and improved hip scores for revision THA With severe bone defects. Clin Orthop Relat Res 474(3):731–740. https://doi.org/10.1007/s11999-015-4587-0
doi: 10.1007/s11999-015-4587-0
pubmed: 26467611
Chiarlone F, Zaniarto A, Cavagnaro L et al (2020) Acetabular custom-made implants for severe acetabular bone defect in revision total hip arthroplasty: a systematic review of the literature. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-020-03334-5
doi: 10.1007/s00402-020-03334-5
pubmed: 31960168
Fröschen FS, Randau TM, Hischebeth GTR et al (2019) Mid-term results after revision total hip arthroplasty with custom-made acetabular implants in patients with Paprosky III acetabular bone loss. Arch Orthop Trauma Surg 140(2):263–273. https://doi.org/10.1007/s00402-019-03318-0
doi: 10.1007/s00402-019-03318-0
pubmed: 31820093
Hourscht C, Abdelnasser MK, Ahmad SS, Kraler L et al (2017) Reconstruction of AAOS type III and IV acetabular defects with the Ganz reinforcement ring: high failure in pelvic discontinuity. Arch Orthop Trauma Surg 137(8):1139–1148. https://doi.org/10.1007/s00402-017-2731-x
doi: 10.1007/s00402-017-2731-x
pubmed: 28623470