ABSTRACT
The treatment of extensive acetabular bone loss and pelvic discontinuity in revision total hip arthroplasty remains challenging. We report our preliminary experience with the modified custom-made triflanged acetabular reconstruction ring (MCTARR) in the management of such situations. The MCTARR is a custom-made metal reinforcement ring with a trabecular surface to encourage bone ingrowth and a bulky trabecular metal augmentation to fill the acetabular defects, designed to achieve initial and long-term stability. A custom-made drilling jig is used to achieve optimal screw positioning. The clinical and radiological short-term follow-up (10-58 months) of our first six cases treated with this new technique show acceptable to good results. None of the reconstructions failed or had to be revised. Clinical results were satisfactory. Radiographs showed good screw positioning. The custom-made acetabular drilling jig and the reconstruction of the acetabulum with a titanium porous structure are of added value in the treatment of severe acetabular bone loss and pelvic discontinuity with custom-made triflanged components.
Subject(s)
Acetabulum/surgery , Arthroplasty, Replacement, Hip/instrumentation , Arthroplasty, Replacement, Hip/methods , Plastic Surgery Procedures/methods , Aged , Female , Humans , Male , Middle Aged , Plastic Surgery Procedures/instrumentation , Reoperation , Treatment OutcomeABSTRACT
Tarsometatarsal or Lisfranc fracture dislocations (LFD) are rare, easily overlooked, and lead to long-term disability. Recognition of such injuries is important so that adequate treatment can be provided. As many as 20% of LFD are either misdiagnosed or overlooked, and these can be a permanent source of pain in polytraumatic patients after the major fractures have healed. It is important to distinguish pure Lisfranc joint dislocations (LD) from LFD and Chopart-Lisfranc dislocations (CLFD). Here, we discuss the protocols for treating these different types of injury.
