Reverse reaming distraction for acetabular reconstruction of chronic pelvic discontinuity

Jing-Yang Sun,Yin-Qiao Du,Yong-Gang Zhou,Ming Ni,Guo-Qiang Zhang,Hai-Yang Ma,Jun-Min Shen,Ji-Ying Chen

doi:10.1186/s13018-020-01701-x

Abstract

BackgroundThe acetabular distraction technique demonstrates encouraging radiographic and clinical outcomes in treating chronic pelvic discontinuity. The aim of this study is to describe a modified distraction technique and to show our results.MethodsThis study identified 12 cases of chronic pelvic discontinuity undergoing primary or revision total hip arthroplasty (THA) with the technique of reverse reaming distraction between July 2015 and November 2018. All 12 patients had a minimum follow-up of 12 months. Radiographs were reviewed to inspect for component loosening. Clinical assessment included the Harris hip score (HHS) and an ambulatory scoring system.ResultsAt the time of final follow-up, no patient was revised. One patient had up to 1 cm migration of the cup in a horizontal or vertical direction and more than 20° change in the abduction angle but was asymptomatic. In the remaining 11 patients, no migration of the component was detected. Both the HHS and ambulatory score showed improvement in all patients. There were no perioperative complications. No postoperative dislocation occurred.ConclusionsReverse reaming distraction is a feasible technique in treatment of chronic pelvic discontinuity, with encouraging results at early term. However, ongoing follow-up is required to determine the long-term prognosis in patients receiving this technique.

Highlights

The acetabular distraction technique demonstrates encouraging radiographic and clinical outcomes in treating chronic pelvic discontinuity
Pelvic discontinuity is an uncommon problem in acetabular revisions or in complex primary total hip arthroplasty (THA), which is defined by the absence of bridging bone between the superior and inferior hemipelvis [1]
Due to substantial bone loss associated with pelvic discontinuity, the acetabular reconstruction remains a challenging task

Summary

Introduction

The acetabular distraction technique demonstrates encouraging radiographic and clinical outcomes in treating chronic pelvic discontinuity. Pelvic discontinuity is an uncommon problem in acetabular revisions or in complex primary THAs, which is defined by the absence of bridging bone between the superior and inferior hemipelvis [1]. Due to substantial bone loss associated with pelvic discontinuity, the acetabular reconstruction remains a challenging task. Several options are available for treating pelvic discontinuity. Acute pelvic discontinuity is amenable to posterior column compression plating and implantation of conventional hemispherical acetabular cup [2]. The main management options for chronic pelvic discontinuity include structural allograft with a cage, cup-cage construct, custom triflange acetabular component (CTAC), or acetabular distraction technique [4]

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