PhD Scientific Days 2022

Clinical Medicine IV.

Surgical treatment methods of hip prosthesis loosening causing extensive acetabular bone defects

Text of the abstract

Introduction
Periacetabular bone defects have always been a huge challenge for surgeons doing revision
hip arthroplasty. Cup-cage acetabular revision systems are a good solution for most of the
complicated revisions, but in a small number of cases, these prostheses proved inadequate.
Before custom 3D-printed acetabular components were an option, these patients often
ended up with Girdlestone position or arthrodesis. Three-dimensional printing (3DP) is an
evolving technology that could provide patient-specific implants for arthroplasty, taking into
account anatomical variations and defects.
Aims
Our study aims to analise the different methods of acetabular reconstruction in regards of
functionality, complications and outcome.
Methods
We analized all the acetabular revision hip surgeries that were done on our Clinic from the
last ten years. 860 patients were included. The pre- and postoperative X-rays were analised,
the Paprosky Classification method was used to group the different acetabular defects.
Overviewing all our cases revision surgery, the chosen method of solution, and its effectivity
was measused with the help of the X-ray taken before and years after the surgery.
Results
In case, the correct method was chosen the long term follow showed good result years after
the surgery. In case of failed surgery, not the optimal method was chosen and needed early
revision.
Conclusion
Over the years, with the development of the surgical methods and technics, the solution of
more demanding cases become possible. Because of that, it can be said that the Girdlestone
procedure is a thing of the past. The use of the correct surgical technique promisses good
long term results even after a complicated anatomical situation.
Funding
The increase in the number and the complexity of the acetalular revision is a big challenge
for the orthopedic surgeon. The technical progress plays a major role in resolving difficult
anatomical situations. The development of 3D surgical techniques will in this in the future,
which I will try to help with my PhD work.