THR: Acetabular Component

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 - See: Total Hip Replacement Menu / acetabular component revision:

- Surgical Technique:
    - preoperative planning:
           - acetabular biomechanics:
           - operative considerations for hip dyplasia
           - protrusio
           - types of components:
                  - cementless components:
                  - cemented acetabular component:
           - clinical exam:
                  - note the amount of standing lordosis and the amount of hip abduction;
                  - adduction contracture may cause the pelvis to tilt downward which might over-estimate the amount of hip abduction;
    - acetabular exposure:
           - if exposure is not optimal, then consider trochanteric osteotomy;
    - re-establish anatomy of the acetabular floor:
    - reaming technique:
    - component and polyethylene insertion: (cementless components)
    - component position:
    - screw placement:
    - bone grafting for acetabular defects: 
    - complications:
           - acetabular fracture:
                  - acetabuli should not be underreamed by more than 1 mm, especially in osteoporotic bone;
                  - underreaming of the acetabulum by two milimeters may result in frx in 20-25% of cases;
                  - when intra-operative fracture is recognized intra-operatively, then augment the component with as many acetabular screws as possible; 
                  - refereneces:
                         - Periprosthetic frx of the acetabulum during and followingg total hip arthroplasty.  JJ Callaghan.  JBJS Vol 79-A. No 9. Sep 1997. p 1416. 
                         - Fracture of the acetabulum during insertion of an oversized hemispherical component. 
                         - Intraoperative Fractures of the Acetabulum During Primary Total Hip Arthroplasty 
           - acetabular component loosening: 
           - screw insertion injuries;
           - osteolysis
           - protrusio: 
           - dislocation 
                  - references: 
                          - The elevated-rim acetabular liner in total hip arthroplasty: relationship to postoperative dislocation. 

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- Radiographic Evaluation:
    - preop acetabular x-ray evaluation:
           - protrusio:
                  - references:
                         - Radiographic measurements in protrusio acetabuli.
           - bone grafting for acetabular defects:
           - references:
                  - The acetabular teardrop and its relevance to acetabular migration.
                  - Bone-grafting in total hip replacement for acetabular protrusion.
    - postop radiographic evaluation:
           - acetabular component loosening:
           - component position;
           - polyethylene wear:
           - osteolysis:
                  - references:
                         - Severe Osteolysis of the Pelvis in Association with Acetabular Replacement without Cement.
                         - The relationship between design, position, and wear of acetabular components inserted w/o cement and development of pelvic osteolysis. 
                         - Are cementless acetabular components the cause of excess wear and osteolysis in total hip arthroplasty.

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   - acetabular component revision:

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Misc Articles

Secondary total hip replacement after fractures of the femoral neck.

Current status of acetabular fixation in primary total hip arthroplasty.

Failure of the Mecring screw-ring acetabular component in total hip arthroplasty. A three to seven-year follow-up study.









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