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Copyright ©2012 Baishideng Publishing Group Co.
World J Orthop. Jul 18, 2012; 3(7): 95-100
Published online Jul 18, 2012. doi: 10.5312/wjo.v3.i7.95
Table 1 Paprosky classification system for acetabular defects[26]
Description
TypeSuperior hip center migrationIs chialosteolysisKohler lineTeardrop
IMinimalNoneIntactIntact
IIAMildMildIntactIntact
IIBModerateMildIntactIntact
IICMildMildDisruptedModerate lysis
IIIASevereModerateIntactModerate lysis
IIIBSevereSevereDisruptedSevere lysis
Table 2 Reconstruction options for acetabular revision
Acetabular revision optionClinical pearls
Isolated liner exchangeThe stability and orientation of the acetabular metal component should be confirmed at the time of revision, liner may be cemented if needed
Hemispheric porous-coated cupMay be used in conjunction with adjunct techniques of bone grafting, screw fixation recommended
Highly porous metal cupAppears to be effective in achieving biologic fixation in cases of severe bone defects, augments may be used for structural support, cup-cage construct can be used to offload cup
Antiprotrusio cageUseful in cases of severe bone defects or pelvic discontinuity, spans areas of healthy host bone and accommodates bone grafting deep to the cage, relies on mechanical fixation alone
Customized triflange implantRequires several weeks or month to obtain implant, serves as a good salvage option in cases of catastrophic bone loss and discontinuity, may achieve biologic fixation