- See: Total Hip Replacement Menu / acetabular component revision:
- Surgical Technique:
- preoperative planning:
- acetabular biomechanics:
- operative considerations for hip dyplasia
- protrusio
- types of components:
- press fit components:
- cemented acetabular component:
- acetabular component revision
- clinical exam:
- note the amount of standing lordosis and the amount of hip abduction;
- adduction contracture may cause pelvis to tilt downward which might over-estimate hip abduction;
- acetabular exposure:
- if exposure is not optimal, then consider trochanteric osteotomy;
- re-establish anatomy of the acetabular floor:
- reaming technique:
- component insertion: (press fit components)
- component position: (anteversion and inclination)
- screw placement:
- poly insertion
- 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 frx is recognized intra-op, then augment component with as many acetabular screws as possible;
- references:
- Periprosthetic fracture of the acetabulum during and following total hip arthroplasty.
- 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.
- The use of a lipped acetabular liner decreases the rate of revision for instability after total hip replacement: a study using data from the New Zealand Joint Registry.
- Radiographic Evaluation:
- preop acetabular x-ray evaluation:
- protrusio vs DDH
- reference:
- 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 the design, position, and articular wear of acetabular components inserted without cement and the development of pelvic osteolysis.
- Are cementless acetabular components the cause of excess wear and osteolysis in total hip arthroplasty?
- acetabular component revision