Evidence map›Paper›PMID 37145143›Full record

ArticleInternational orthopaedics2023

Beyond type III Paprosky acetabular defects: are partial pelvic replacements with iliosacral fixation successful?

Yannik Hanusrichter, Carsten Gebert, Sven Frieler, Marcel Dudda, Jendrik Hardes, Arne Streitbuerger, Lee Jeys, Martin Wessling

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Article in International orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Yannik HanusrichterDepartment of Tumour Orthopaedics and Revision Arthroplasty, Orthopaedic Hospital Volmarstein, Lothar-Gau-Str. 11, 58300, Wetter, NRW, Germany. HanusrichterY@esv.de.ORCID http://orcid.org/0000-0003-4940-6928
Carsten GebertDepartment of Tumour Orthopaedics and Revision Arthroplasty, Orthopaedic Hospital Volmarstein, Lothar-Gau-Str. 11, 58300, Wetter, NRW, Germany.
Sven FrielerDepartment of Tumour Orthopaedics and Revision Arthroplasty, Orthopaedic Hospital Volmarstein, Lothar-Gau-Str. 11, 58300, Wetter, NRW, Germany.
Marcel DuddaCenter for Musculoskeletal Surgery, University Hospital of Essen, Essen, Germany.
Jendrik HardesCenter for Musculoskeletal Surgery, University Hospital of Essen, Essen, Germany.
Arne StreitbuergerCenter for Musculoskeletal Surgery, University Hospital of Essen, Essen, Germany.
Lee JeysOncology Department, The Royal Orthopaedic Hospital, Birmingham, UK.
Martin WesslingDepartment of Tumour Orthopaedics and Revision Arthroplasty, Orthopaedic Hospital Volmarstein, Lothar-Gau-Str. 11, 58300, Wetter, NRW, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSupra-acetabular bone loss close beyond the sciatic notch is one of the most challenging defect types for stable anatomical reconstruction in revision arthroplasty. Using reconstruction strategies from tumour orthopaedic surgery, we adapted tricortical trans-iliosacral fixation options for custom-made implants in revision arthroplasty. The aim of the present study was to present the clinical and radiological results of this extraordinary pelvic defect reconstruction.

methodsBetween 2016 and 2021, 10 patients with a custom-made pelvic construct using tricortical iliosacral fixation (see Fig. 1) were included in the study. Follow-up was 34 (SD 10; range 15-49) months. Postoperatively CT scans evaluating the implant position were performed. Functional outcome and the clinical results were recorded.

resultsImplantation was possible as planned in all cases in 236 (SD 64: range 170-378) min. Correct centre of rotation (COR) reconstruction was possible in nine cases. One sacrum screw crossed a neuroforamen in one case without clinical symptoms. During the follow-up period, four further operations were required in two patients. There were no individual implant revisions or aseptic loosening recorded. The Harris Hip Score increased significantly from 27 Pts. to 67 Pts. with a mean improvement of 37 (p < 0.005). EQ-5D developed from 0.562 to 0.725 (p = 0.038) as a clear improvement in quality of life.

conclusionCustom-made partial pelvis replacement with iliosacral fixation offers a safe solution in "beyond Paprosky type III defects" for hip revision arthroplasty. Due to meticulous planning, precise implantation with good clinical outcome can be achieved. Furthermore, the functional outcome and patient satisfaction increased significantly showing promising early results with a relatively low complication rate.

Indexed as

Arthroplasty, Replacement, HipHip ProsthesisAcetabulumFollow-Up StudiesHumansPelvisProsthesis FailureQuality of LifeReoperationRetrospective StudiesTreatment OutcomeAseptic looseningIliosacral fixationPaproskyPJIRevision arthroplastyrTHA

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.