Periprosthetic fractures of the acetabulum: revision endoprosthetics

Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
F-J DallyS Gravius

Abstract

Periprosthetic acetabular fractures are an increasing severe complication in revision arthroplasty. A differentiation is made between periprosthetic acetabular fractures (acute/traumatic fractures) and insufficiency fractures (chronic fractures). This article introduces a novel treatment algorithm that provides assistance in therapeutic decision making for implant selection and the anchoring philosophy based on diagnostic decision criteria and the relevant load-bearing osseous structures, taking the defect situation into account. The article provides an overview of original and review articles. The essential criteria for decisions in treatment planning are based on the stability of the primary cup, the load-bearing ability of the main anatomical structures and the resulting defect situation. For insufficiency fractures the reason for the revision and therefore the exclusion of periprosthetic joint infections (PJI) must additionally be considered. In the case of proven PJI a two-stage or multistage prosthesis exchange must be carried out. Based on the extent of apparent bony defects and pelvic discontinuity, the spectrum of treatment options ranges up to implantation of individual patient custom-made acetabular components. This ...Continue Reading

References

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