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Planning and repair of acetabular defects in revision total hip arthroplasty: Simple solutions for complex problems

Published in N°014 - November / December 2021
Article viewed 231 times

Planning and repair of acetabular defects in revision total hip arthroplasty: Simple solutions for complex problems

By Max Jaenisch, Dieter Christian Wirtz in category UPDATE
Klinik und Poliklinik für Orthopädie und Unfallchirurgie [Department of Orthopaedics and Trauma Surgery], Universitätsklinikum Bonn [University Hospital Bonn]

The implantation of a total hip arthroplasty (THA) is one of the most successful surgeries in the entire field of medicine and is therefore rightly called the surgery of the century. We are seeing growing numbers of implants in the developed world. However, the consequence of a larger number of primary implant procedures also results in a larger number of revision procedures.

Introduction

The implantation of a total hip arthroplasty (THA) is one of the most successful surgeries in the entire field of medicine and is therefore rightly called the surgery of the century [1]. We are seeing growing numbers of implants in the developed world [2]. However, the consequence of a larger number of primary implant procedures also results in a larger number of revision procedures [3]. Revision hip arthroplasty (RHA) surgery is associated with a reduced service life of the implant and an increased rate of infection, especially in young patients aged 55 years and under [3]. The growing use of THA also results in an extension of the indication for surgery, with an increasing number of younger and more active patients with symptomatic hip osteoarthritis are fitted with THAs. The medical community has therefore reached a clear consensus. A steadily increasing incidence of revision and re-revision surgeries is expected in the near future [3].

The most common causes for revision surgery are loosening of the indwelling prosthesis due to abraded particles and periprosthetic joint infection. Both scenarios are associated with damage to the acetabular bone substance. This is a problem for the primary stable embedding of the implant and recovery of the physiological joint...

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