Oct 26, 2009 this animation shows the difference between true and planar anteversion. Anatomical variance in acetabular anteversion does not. However, this technique is only used in cases with more extensive bone loss. Good fracture healing and uneventful osseous ingrowth can be.
The acetabular angle is a radiographic measurement used when evaluating potential developmental dysplasia of the hip ddh. Prominent sublabral osteophyte formation at the superior and posterior acetabulum results in increased acetabular anteversion and overcoverage of the femoral head. Total hip arthroplasty for hip arthritis with protrusio. The hemispherical porous acetabular component fixed by pressfit technique and additional screws. The plain film radiograph findings and ct scan findings were compared with those of two control populations 8 patients with.
Outcomes after surgical treatment of acetabular fractures. These three segments join at the triradiate cartilage, a yshaped synchondrosis centered on the acetabulum. The authors excluded patients with bone defects smaller than 30% of the acetabulum did not need structural grafting and greater than 50% of the acetabulum. Anteversion and inclination of an acetabular cup youtube. Objective to describe the radiographic and computed tomography ct scan features of iliopsoas impingement on the acetabular component ipi in total hip arthroplasty method eight cases of iliopsoas impingement were diagnosed and confirmed by surgical revision. Pdf the hemispherical porous acetabular component fixed by. Widmer12 reported a protractor to measure it on the plain radiographs. Pdf the hemispherical porous acetabular component fixed. Intraoperative acetabular fracture is a rare complication of primary total hip arthroplasty tha, typically occurring during impaction of the cementless acetabular component. Ganz r, gill tj, gautier e, ganz k, krugel l, berlemann u. Focal concavity of posterior superior acetabulum and its relation with acetabular dysplasia and retroversion in adults without advanced hip.
Telechargement dadobe acrobat reader dc lecteur pdf gratuit. Jan, 2015 the orientation of the acetabular cup component of a total hip arthroplasty can be evaluated in a number of ways, utilizing a myriad of imaging techniques and measurement parameters, including intraoperative surgical estimates, postoperative radiographs, and crosssectional imaging such as computed tomography ct and magnetic resonance imaging mri. Pelvic discontinuity caused by acetabular overreaming. The acetabulum is reamed sequentially until twopoint contact is made and bleeding bone is seen usually anterosuperior and posteroinferior. Nov 30, 2016 chapter 89 acetabular reconstruction classification of bone defects and treatment options geoffrey wright and wayne g. Mcarthur 1, ettore vulcano 2, michael cross 3, joseph nguyen 3, alejandro g. Download free adobe acrobat reader dc software for your windows, mac os and android devices to view, print, and comment on pdf documents. Pelvic radiographs were correlated with surgical findings. Only true anteversion gives a reliable picture of the actual placement of the cup with respect to the anatomy of the pelvis. Acetabula definition of acetabula by the free dictionary. Aug 31, 20 the supporting structures of the acetabulum used by the paprosky classification as seen on routine ap radiographs of the pelvis include the teardrop medial wall, red arrow, hip center migration superior walldome, green bracket, the kohler line anterior columnmedial wall, blue line, and the presence or absence of ischial lysis posterior columnposterior wall, yellow square. Acetabulum, showing the cupshaped cavity a, and its articulation with the femur b.
Results an oversized cup was found in four hips with ipi 50% and in one hip with another complication 6%. In an attempt to better define these defects, classification systems are used. Download fulltext pdf acetabular reconstruction using a free fibular autograft in total hip arthroplasty revisions article pdf available in international orthopaedics 3812 july 2014 with. Restoration of posterior columnar continuity was achieved with an autologous fibular graft and a. It has been suggested that variances in the anatomy of the acetabulum determine the type of hip fracture in elderly patients. Contribution of acetabular labrum to articulating surface area and femoral head coverage in adult hip joints. Acetabular component orientation in total hip arthroplasty. Pelvis and acetabulum orthopaedic trauma association ota. Here we report an unusual case of pelvic discontinuity caused by overreaming of the acetabulum during primary tha. The posterior column is characterized by the dense bone at the greater sciatic notch and follows the dotted line distally through the center of the acetabulum, the. They were either posterior wall fractures in isolation or as part of associated acetabular fractures as classified by letournel. Compared with the medial edge of the acetabular sourcil, point a was clear in all patients, and its. It arises from, and is supported by, the innominate bone os coxa, which forms from three ossification centers. Volume 58, issue 1, januaryfebruary 2014, pages 5759.
Anatomy the cupshaped cavity at the base of the hipbone into which the ballshaped head of the femur fits. The anterior and posterior columns of the acetabulum were defined based on the. We use cookies to offer you a better experience, personalize content, tailor advertising, provide social media features, and better understand the use of our services. To investigate this issue, acetabular cups kyon, zurich were implanted into artificial bone sawbones, malmo in accordance with manufacturer instructions, and loaded in mediolateral rotation under laboratory conditions. Pelvic discontinuity occurs when there is loss of continuity between the superior and inferior aspects of the pelvis as a result of disruption of both the anterior and posterior columns. Pelvic discontinuity caused by acetabular overreaming during. Total hip arthroplasty is a successful procedure for the treatment of endstage hip arthritis. Revision hip arthroplasty classification and algorithmic. In patients having protrusio acetabuli, reconstruction of the medial wall of the acetabulum with bone graft and stainless steel metal wire mesh and protection of the graft during the healing process is of paramount importance to prevent recurrence of protrusio and failure. Coronal inclination of the acetabular cup was normal in the ipi group and in the two. These three segments join at the triradiate cartilage, a y. The acetabulum anteversion is an important prognostic factor after thr. Superiority of the modified tonnis angle over the tonnis.
Please pay particular attention at specific points in a procedure when one of the following messages appears. The supporting structures of the acetabulum used by the paprosky classification as seen on routine ap radiographs of the pelvis include the teardrop medial wall, red arrow, hip center migration superior walldome, green bracket, the kohler line anterior columnmedial wall, blue line, and the presence or absence of ischial lysis posterior columnposterior wall, yellow square. The lectures have been compressed, for ease of download. A prospective study was conducted from february 2005 to september 2005 at tameside.
Only true anteversion gives a reliable picture of the actual placement. Aaos femoral deficiency classification dantonio j, mccarthy jc, bargar wl, et al. Pinzamiento femoroacetabular by luis saavedra on prezi. Acetabular version measurement in total hip arthroplasty. Chapter 89 acetabular reconstruction classification of bone defects and treatment options geoffrey wright and wayne g. Surgical approaches to fractures of the acetabulum. The acetabulum is more than just the socket for the femoral head. Aseptic loosening of cementless acetabular cups is a recognised problem.
It is most useful in patients who have started to ossify the epiphysis since ossification diminishes the usefulness of ul. Previous studies have demonstrated that underreaming of the acetabulum and insertion of an oversized acetabular component without cement may predispose to intraoperative acetabular fracture. Letournel classification for acetabular fractures orthobullets. Della valle, eduardo salvati 3 1 mayo clinic, rochester, minnesota usa 2 university of insubria, varese italy 3 hospital for special surgery, new york usa original article. The posterior column is characterized by the dense bone at the greater sciatic notch and follows the dotted line distally. He studied the relationship between anteversion and the short axis s and the total length tl of the projected crosssection of the cup along the short axis, and approximated with linear regression. Your fractured acetabulum a guide for patients about the injury and. Abnormal modeling of the acetabulum, increased joint space, effusion, small iliac wings and intraosseous herniation of fluid were found in four out of five patients. B the two columns are linked to the sacral bone by the sciatic buttress. Acetabula definition of acetabula by medical dictionary.
All the patients were painfree and there was no sign of. Oct 08, 2014 r 1 and r 2 represented the radii of the femoral head and acetabulum, respectively. Lacetabulum ou cotyle, selon lancienne nomenclature anatomique, parfois aussi appele. This is similar to the technique described in the posterior column plating and cementless acetabular component section earlier. The supporting structures, including the acetabular walls and columns, are all intact and with no hip center component migration. There are small femoral head neck junction osteophytes superiorly and posteriorly. Historically routine work up of a patient with a fracture neck of femur has always included an anteroposterior ap and a lateral view of the hip. Pdf focal concavity of posterior superior acetabulum and. The angle is formed by a horizontal line connecting both triradiate cartilages hilgenreiner line and a second line which extends along the. R 1 and r 2 represented the radii of the femoral head and acetabulum, respectively. Acetabular fractures are uncommon, and generally occur from. Intraoperative occurrence of an acetabular fracture is a rare complication of primary total hip arthroplasty tha.
Lateral radiograph of the hip in fracture neck of femur. Les tableaux sont exclusivement disponibles en format pdf. The isthmus is nonsupportive the metaphysis is severely damaged and nonsupportive. Pdf acetabular reconstruction using a free fibular. We help you diagnose your acetabulum case and provide detailed descriptions of how to manage this and hundreds of other pathologies. The acetabular angle is a radiographic measurement used when evaluating potential developmental dysplasia of the hip ddh it is most useful in patients who have started to ossify the epiphysis since ossification diminishes the usefulness of ultrasound. The aim of the study was to know whether a lateral view of hip influenced the decision of an orthopedic surgeon regarding management at a district general hospital. Citescore values are based on citation counts in a given year e. This animation shows the difference between true and planar anteversion. Instability of the hip is most common in posterior types but may also be present with a large free frag ment of the quadrilateral plate or in anterior types with. The orientation of the acetabular cup component of a total hip arthroplasty can be evaluated in a number of ways, utilizing a myriad of imaging techniques and measurement parameters, including intraoperative surgical estimates, postoperative radiographs, and crosssectional imaging such as computed tomography ct and magnetic resonance imaging mri. Wed like to understand how you use our websites in order to improve them. Degenerative cystic change along the superior acetabulum. Acetabular and femoral defect classification algorithmic approach to the reconstruction in hip revision arthroplasty.
272 369 138 1191 1535 238 123 115 1428 301 546 1148 1017 593 465 84 820 232 1585 1640 1083 299 312 1363 920 493 1466 835 661 1087 787 1578 426 526 202 751 1331 260 25 290 867 490 1310 142 616