|Pelvic discontinuity treated with custom triflange component: a reliable option.|
|PMID: 21997785 Owner: NLM Status: MEDLINE|
|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.
|Michael J Taunton; Thomas K Fehring; Paul Edwards; Thomas Bernasek; Ginger E Holt; Michael J Christie|
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|Type: Journal Article; Multicenter Study|
|Title: Clinical orthopaedics and related research Volume: 470 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2012 Feb|
|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|
|Languages: eng Pagination: 428-34 Citation Subset: AIM; IM|
|Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Arthroplasty, Replacement, Hip / adverse effects, economics, instrumentation*
Health Care Costs
Hip Joint / physiopathology, radiography, surgery*
Hip Prosthesis* / economics
Osteolysis / economics, etiology, physiopathology, radiography, surgery*
Range of Motion, Articular
Recovery of Function
Tomography, X-Ray Computed
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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