scholarly journals Pelvic Discontinuity Caused by Acetabular Overreaming during Primary Total Hip Arthroplasty

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Iori Takigami ◽  
Yoshiki Ito ◽  
Takashi Mizoguchi ◽  
Katsuji Shimizu
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Rare Complication ◽  
Acetabular Reconstruction ◽  
Fibular Graft ◽  
Intraoperative Complication ◽  
Pelvic Discontinuity ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Intraoperative acetabular fracture is a rare complication of primary total hip arthroplasty (THA), typically occurring during impaction of the cementless acetabular component. Here we report an unusual case of pelvic discontinuity caused by overreaming of the acetabulum during primary THA. Restoration of posterior columnar continuity was achieved with an autologous fibular graft and a reconstruction plate. Wall defects and cavitary defects were reconstructed with metal mesh and femoral head allograft, followed by placement and fixation of a Kerboull-type acetabular reinforcement device. Previous reports of acetabular fracture during THA have indicated that it has a relatively good prognosis without extensive treatment. However, to our knowledge, there has been no report of pelvic discontinuity necessitating acetabular reconstruction surgery as an intraoperative complication of primary THA.

Cementless Acetabular Reconstruction in Primary Total Hip Arthroplasty: Evaluation at a Minimum of 20 Years

2007 ◽  
Vol 22 (2) ◽  
pp. 313
Author(s):  
Craig J. Della Valle ◽  
Nate Mesko ◽  
Laura Quigley ◽  
Richard A. Berger ◽  
Aaron G. Rosenberg ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Reconstruction ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

scholarly journals Total Hip Arthroplasty with Tantalum Constructions

2012 ◽  
Vol 19 (1) ◽  
pp. 24-29
Author(s):  
V Yu Murylev ◽  
Dmitriy Igorevich Terent'ev ◽  
P M Elizarov ◽  
Ya A Rukin ◽  
G M Kazaryan ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Acetabular Reconstruction ◽  
Defect Classification ◽  
Common Complication ◽  
Total Hip ◽  
Primary Arthroplasty ◽  
Selection Of ◽  
Primary Total Hip Arthroplasty

Results of acetabular reconstruction with tantalum constructions were analyzed for 56 patients (25 men and 31 women) aged 35 to 70 years. Primary arthroplasty was performed in 30 and revision intervention in 26 patients. In case of primary total hip arthroplasty the following etiologic factors were considered: posttraumatic acetabulum deformity (21 patients), deficit of acetabular walls resulted from dysplasia (4), femoral head protrusion (5). Evaluation of the defect and selection of tantalum construction were made using defect classification by W.G. Paprosky. Results were assessed by Harris scale at terms 3,6 and 12 months after operation and every year thereafter. Excellent, good and satisfactory results were achieved in 96.8% of cases. The most common complication was the dislocation of hip implant head. It developed in 2 patients after revision arthroplasty and in 1 patient after primary total hip arthroplasty.

scholarly journals Management of intraoperative acetabular fracture in primary total hip arthroplasty

2020 ◽  
Author(s):  
Juncheng Li ◽  
Quanbo Ji ◽  
Ming Ni ◽  
Qingyuan Zheng ◽  
Jinyang Sun ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Acetabular Fractures ◽  
Fracture Rate ◽  
X Rays ◽  
Total Hip ◽  
Acetabular Components ◽  
Primary Total Hip Arthroplasty

Abstract Background: Intraoperative acetabular fracture（IAF）is a rare complication of primary total hip arthroplasty（THA）. The previous reports have lacked a sufficiently large number of subjects to allow for an analysis of the causes and appropriate treatment of this problem.Methods: Between 2015 to 2018, 4,888 primary THA were enrolled. We retrospectively reviewed the records in our Total Joint Registry Database and found that 24 patients (24 hips) had sustained intraoperative acetabular fractures. Twenty-four patients（16 females and 8males）were all treated with a posterolateral approach using uncemented components. Twenty patients（83.3%）underwent supplemental screw fixation, of which 2 patients were treated with steel plate fixation. Two patients’ femoral heads were used as a graft. In 4 patients（16.7%）, the acetabular components were judged to be stable despite the fracture and no additional treatment was performed. All patients were evaluated clinically with Harris Hip Scores (HHS) and radiographically with serial X-rays which follow up for a mean period of 34.0±12.6 months. We evaluated the anatomic locations, causes, treatments, and outcome of the fractures to study the treatment method and effect of intraoperative acetabular fracture during operation. Results: The fracture rate associated with uncemented components was 0.49%. In 17(70.8%) of these patients, the fracture was noted during the impaction of the real acetabular component. Six patients（25%）with Ankylosing Spondylitis had fractures, 4 in the anterior wall, and 1 in the anterior column, because the patient with hip joint fusion needs a to pre-osteotomy before the dislocation. The HHS score increased from 30.8±9.7 preoperatively to 90.2±4.2 postoperatively. All the latest x-ray showed that the fracture did not move, and there is no translucent line formed in the acetabular cup bone interface.Conclusion: Intraoperative acetabular fractures are rare complications of THA, and most commonly occur during the implantation of the acetabular components. It is necessary to prevent the occurrence of fractures as much as possible even if the fractures are found during the operation. It should be noted that patients with ankylosing spondylitis involving hip joints during THA surgery must be careful to prevent IAFs during dislocation and pre-osteotomy.

Fatal Fat Embolism following Femoral Head Resection in Total Hip Arthroplasty

2008 ◽  
Vol 18 (4) ◽  
pp. 332-334 ◽  
Author(s):  
N.M. Walker ◽  
T. Bateson ◽  
P. Reavley ◽  
D. Prakash
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Rare Complication ◽  
Femoral Shaft ◽  
Fat Embolism ◽  
Total Hip ◽  
Intramedullary Reaming ◽  
Embolism Syndrome ◽  
Primary Total Hip Arthroplasty

We report a rare complication during primary total hip arthroplasty. A fatal fat pulmonary embolism immediately followed removal of the femoral head, prior to further preparation of the acetabulum or femoral shaft. Fat embolism syndrome is a well-known complication during total joint arthroplasty, usually attributed to preparation of the femoral shaft, particularly intramedullary reaming and insertion of the prosthesis. These risk factors have previously been identified in the literature. We believe that this case highlights the need for further research to establish the intramedullary pressures during the processes of dislocation and resection of the femoral neck and the attendant risk.

scholarly journals Management of intraoperative acetabular fracture in primary total hip arthroplasty

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Juncheng Li ◽  
Quanbo Ji ◽  
Ming Ni ◽  
Qingyuan Zheng ◽  
Jingyang Sun ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

scholarly journals Intrapelvic Dislocation of a Femoral Trial Head During Primary Total Hip Arthroplasty Requiring Laparotomy for Retrieval

2013 ◽  
Vol 7 (1) ◽  
pp. 169-171 ◽  
Author(s):  
Mustafa Citak ◽  
Till Orla Klatte ◽  
Akos Zahar ◽  
Kimberly Day ◽  
Daniel Kendoff ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Procedure ◽  
Posterior Approach ◽  
Lateral Position ◽  
Intraoperative Complication ◽  
Total Hip ◽  
Standard Posterior Approach ◽  
Primary Total Hip Arthroplasty

Background and Purpose: Total hip arthroplasty (THA) is a safe and reliable surgical procedure. However, THA also has intra- and postoperative complications. A dreaded and frustrating intraoperative complication during total hip arthroplasty is dislocation of the femoral trial head from the neck into the pelvis. Methods: Here, we report on the case of a 71-year old female patient with osteoarthritis of the left hip. Total hip arthroplasty was performed in a lateral position through a standard posterior approach. During intraoperative trial reduction, the femoral trial head dissociated from the taper and dislocated into the psoas compartment. Several unsuccessful attempts, including an additional ventral approach, were made to immediately retrieve the femoral trial head. Results and interpretation: Postoperative a Computerized Tomography (CT) was performed to locate the trial head, a secondary explorative laparotomy was undertaken to retrieve it. The retrieval of the femoral trial head should be performed in a planned second surgical procedure to avoid possible complications during the manipulation necessary for retrieval.

Primary total hip arthroplasty for displaced intracapsular fracture of the femoral neck: Medium-term functional and radiographic outcomes

Open Medicine ◽  
2008 ◽  
Vol 3 (2) ◽  
pp. 207-213
Author(s):  
Valér Džupa ◽  
Pavel Pazdírek ◽  
Vladimír Pacovský ◽  
Jan Bartoníček ◽  
Jiří Skála-Rosenbaum
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Intracapsular Fracture ◽  
Intraoperative Complication ◽  
Total Hip ◽  
Early Postoperative Complications ◽  
Primary Total Hip Arthroplasty

AbstractThe number of complications after primary total hip arthroplasty for displaced intracapsular fractures of the femoral neck is higher than that after operations for osteoarthritis. The aim of this study is to evaluate the number of complications and mid-term functional and radiological findings of patients after primary THA for displaced intracapsular fractures of the femoral neck. Between 1995 and 1998, we operated on a total of 89 patients for acute displaced intracapsular fractures of the femoral neck, i.e. Garden Type 3 and 4. In all the patients we evaluated intraoperative and early postoperative complications. We reviewed clinical and radiological results in 65 patients. The only intraoperative complication was abruption of the greater trochanter. Early postoperative complications occurred in 13 patients (15%). The specific complications, THA dislocation, occurred in 3 patients. Non-specific complications were recorded in 10 patients. No delayed healing of the surgical wound, neural lesion or early, delayed or late infection was recorded. Of 65 patients followed-up for an average of 78 months (range, 62–109 months), 8 patients underwent revision surgery. Of 57 patients with primary THA, very good and good clinical results according to the Harris Hip Score were recorded in 48 patients (84%) and poor results in only 2 patients (4%). Nine of 57 followed-up patients showed radiological signs of loosening (16%). The radiolucent line could be seen in 3 patients in the region of the cup, in 1 patient in the region of the femoral component and in 5 patients in both components. Clinical complaints that would result in indication for reimplantation were recorded in none of the mentioned patients. Number of complications, functional results and resumption of full self-reliance by patients after THA for an intracapsular fracture of the femoral neck are so positive that we consider the indication of THA for a displaced femoral neck fracture fully justified.

scholarly journals Management of intraoperative acetabular fracture in primary total hip arthroplasty

2020 ◽  
Author(s):  
Juncheng Li ◽  
Quanbo Ji ◽  
Ming Ni ◽  
Qingyuan Zheng ◽  
Jinyang Sun ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Posterolateral Approach ◽  
Fracture Rate ◽  
X Rays ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Abstract Background Intraoperative acetabular fracture(IAF)is a rare complication of primary total hip arthroplasty(THA). Previous report have locked a sufficiently large number of subjects to allow for an analysis of the causes and appropriate treatment of this problem. Methods Between 2015 to 2018, 4,888 primary THA were enrolled. We retrospectively reviewed the records in our Total Joint Registry Database and found that 24 patients (24 hips) had sustained IFAs .24 patients(16 females and 8males)were all treated with posterolateral approach using uncemented components. 20 patients underwent supplemental screw fixation, of which 2 patients were treated with plate fixation. 2 Patients femoral head was used as a graft. In 4 patients, the acetabular component was judged to be stable despite the fracture and no additional treatment was performed All patients were evaluated clinically with Harris Hip Scores (HHS) and radiographically with serial X-rays which follow up for a mean period of 34.0±12.6 months. We evaluated the anatomic location, cause, treatment, and outcome of the fractures. Results The fracture rate associated with uncemented components was 0.49%. In 17(70.8%) of the these patients, the fracture was noted during impaction of the real acetabular component.6 patients with Ankylosing Spondylitis had fracture 4 in anterior wall,1 in anterior column because of patient with hip joint fusion need to pre-osteotomy before dislocation .The HHS score increased from 30.8±9.7 preoperatively to 90.2±4.2 postoperatively. All the latest x-ray showed that the fracture did not move, and there is no translucent line formed in the acetabular cup bone interface.Conclusion IAFs are rare complications of THA, and most commonly occur during the implantation of the acetabular components. It is necessary to prevent the occurrence of fractures as much as possible even if the fractures are found during the operation. It should be noted that patients with ankylosing spondylitis involving hip joints during THA surgery must be careful to prevent IAFs during dislocation and pre-osteotomy.

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