Document Detail


Pelvic discontinuity treated with custom triflange component: a reliable option.
MedLine Citation:
PMID:  21997785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pelvic discontinuity is an increasingly common complication of THA. Treatments of this complex situation are varied, including cup-cage constructs, acetabular allografts with plating, pelvic distraction technique, and custom triflange acetabular components. It is unclear whether any of these offer substantial advantages.
QUESTIONS/PURPOSES: We therefore determined (1) revision and overall survival rates, (2) discontinuity healing rate, and (3) Harris hip score (HHS) after treatment of pelvic discontinuity with a custom triflange acetabular component and (4) the cost of this reconstructive operation compared to other constructs.
METHODS: We retrospectively reviewed 57 patients with pelvic discontinuity treated with revision THA using a custom triflange acetabular component. We reviewed operative reports, radiographs, and clinical data for clinical and radiographic results. We also performed a cost comparison with utilization of other techniques. Minimum followup was 24 months (average, 65 months; range, 24-215 months).
RESULTS: Fifty-six of 57 (98%) were free of revision for aseptic loosening at latest followup. Fifty-four (95%) were free of revision of the triflange component for any reason. Thirty-seven (65%) were free of revision for any reason. Twenty-eight (49%) were free of revision for any reason and free of any component migration and had a healed discontinuity. Forty-six (81%) had a stable triflange component with a healed pelvic discontinuity. Average HHS was 74.8. The costs of the custom triflange implants and a Trabecular Metal cup-cage construct were equivalent: $12,500 and $11,250, respectively.
CONCLUSIONS: In this group of patients with osteolytic pelvic discontinuity, triflange implants provided predictable mid-term fixation at a cost equivalent to other treatment methods.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Authors:
Michael J Taunton; Thomas K Fehring; Paul Edwards; Thomas Bernasek; Ginger E Holt; Michael J Christie
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-11     Completed Date:  2012-02-27     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  428-34     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. taunton.michael@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Acetabulum / radiography,  surgery*
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip / adverse effects,  economics,  instrumentation*
Female
Health Care Costs
Hip Joint / physiopathology,  radiography,  surgery*
Hip Prosthesis* / economics
Humans
Male
Middle Aged
Osteolysis / economics,  etiology,  physiopathology,  radiography,  surgery*
Prosthesis Design
Prosthesis Failure*
Range of Motion, Articular
Recovery of Function
Reoperation
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
United States
Comments/Corrections

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