ArticleArchives of orthopaedic and trauma surgery2025
Quadrilateral surface plating combined with anti-protrusio cage for pelvic discontinuity-a preliminary clinical comparison of a novel technique.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundPelvic discontinuity is a rare but challenging condition in revision hip arthroplasty. Traditional reconstruction with anti-protrusio cages often lacks anterior support, providing no resistance against medial migration or implant protrusion, thereby potentially compromising long-term stability and implant longevity.
methodsThis retrospective study included 13 patients with intraoperatively confirmed pelvic discontinuity who underwent revision total hip arthroplasty between 2014 and 2023. Patients were divided into two groups: Group 1 (n = 8) received anti-protrusio cage reconstruction alone, while Group 2 (n = 5) underwent additional anterior quadrilateral surface plating prior to cage implantation. Clinical and radiological outcomes were assessed with a minimum follow-up of 2 years (mean: 6.3 years), including complications, loosening, and reoperation.
resultsThirteen patients (mean age: 73.3 years) with intraoperatively confirmed pelvic discontinuity were included.Complication and reoperation rates were significantly higher in Group 1 (75%) compared to Group 2 (20%) (p < 0.001). Kaplan-Meier analysis demonstrated superior complication-free survival in Group 2 (80% at 11 years) versus Group 1 (37.5% at 11 years). Periprosthetic fracture rates did not differ significantly (p = 0.21).
conclusionPreliminary results suggest that the addition of quadrilateral surface plating may enhance construct stability and reduce complications. Further studies with larger cohorts and biomechanical validation are warranted.
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