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Acetabular reconstruction using a Kerboull-Tanaka reinforcement device

Published in N°005 - March / April 2020
Article viewed 977 times

Acetabular reconstruction using a Kerboull-Tanaka reinforcement device

By Chiaki TANAKA in category SURGICAL TECHNIQUE
Kyoto Municipal Hospital – Japon / [email protected]

Revision total hip replacements (THR) are becoming increasingly common. However, the loss of acetabular bone stock means reconstruction is required in order to ensure the longevity of the new implant. During a visit to Professor Marcel Kerboull at Cochin Hospital in 1990, I learned a lot about total hip prosthesis and I was in particular impressed by his acetabular reconstruction technique using the Kerboull cross plate and allografts.

Introduction

Revision total hip replacements (THR) are becoming increasingly common. However, the loss of acetabular bone stock means reconstruction is required in order to ensure the longevity of the new implant. During a visit to Professor Marcel Kerboull at Cochin Hospital in 1990, I learned a lot about total hip prosthesis and I was in particular impressed by his acetabular reconstruction technique using the Kerboull cross plate and allografts. It is a brilliant technique which produces excellent results (1). Nevertheless, upon returning to Japan, I encountered several difficulties when trying to copy this same technique. First, allografts were not always available at my hospital. I had to use autografts and hydroxyapatite (HA) granules as my bone replacement, a technique I learned from Professor Hironobu Oonishi. Second, when performing single component revisions to rectify a loosened cup that had initially been implanted higher than the centre of rotation, and where the stem was still stable but was also too high to counter the abnormal acetabular position, I found it hard to reconstruct the true original form of the acetabulum. In these cases, placing the reconstruction device in the anatomical position invariably resulted in unacceptable lengthening of the limb. I...

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