Acetabular bone defects: classification and diagnosis

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  • AAOS classification
  • Paprosky Classification
  • Preoperative assessments
  • Radiologial evaluation for bone quality information
  • Hierarchical approach to preoperative imaging
  • Current classification limitations
  • When to engage CT
  • Magnetic resonance imaging
  • Conclusion

Part 2 | Managing bone defects using large acetabular cups and highly porous augments

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Part 3 | Management strategies for pelvic discontinuity

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AO Recon resources

Contributing experts

This series of articles was created with the support of the following specialists (in alphabetical order):

Theofilos Karachalios

University General Hospital of Larissa at the University of Thessaly, Larissa, Greece

Thomas Kostakos

Henry Dunant Medical Center, Athens, Greece

George A Macheras

Henry Dunant Medical Center, Athens, Greece

The authors thank Maio Chen, medical writer at AO Innovation Translation Center, Switzerland, for contributing to the writing and editing of the articles.

References

  1. Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994 Feb;9(1):33–44.
  2. D'Antonio JA, Capello WN, Borden LS, et al. Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res. 1989 Jun(243):126–137.
  3. Gustilo RB, Pasternak HS. Revision total hip arthroplasty with titanium ingrowth prosthesis and bone grafting for failed cemented femoral component loosening. Clin Orthop Relat Res. 1988 Oct(235):111–119.
  4. Engh CA GA. Cementless revision of failed total hip replacement: an update. Instr Course Lect. 1991;40:189–197.
  5. Gross AE, Duncan CP, Garbuz D, Mohamed EM. Revision arthroplasty of the acetabulum in association with loss of bone stock. Instr Course Lect. 1999;48:57–66.
  6. Saleh KJ, Holtzman J, Gafni AL, et al. Development, test reliability and validation of a classification for revision hip arthroplasty. J Orthop Res. 2001 Jan;19(1):50–56.
  7. Parry MC, Whitehouse MR, Mehendale SA, et al. A comparison of the validity and reliability of established bone stock loss classification systems and the proposal of a novel classification system. Hip Int. 2010 Jan-Mar;20(1):50–55.
  8. Mancino F, Cacciola G, Di Matteo V, et al. Reconstruction options and outcomes for acetabular bone loss in revision hip arthroplasty. Orthop Rev (Pavia). 2020 Jun 29;12(Suppl 1):8655.
  9. Gu A, Adriani M, Malahias MA, et al. Reliability and Validity of Acetabular and Femoral Bone Loss Classification Systems in Total Hip Arthroplasty: A Systematic Review. HSS J. 2020 Oct;16(3):288–295.
  10. Sporer SM, O'Rourke M, Paprosky WG. The treatment of pelvic discontinuity during acetabular revision. J Arthroplasty. 2005 Jun;20(4 Suppl 2):79–84.
  11. Ghanem M, Zajonz D, Heyde CE, Roth A. Acetabular defect classification and management : Revision arthroplasty of the acetabular cup based on 3-point fixation. Orthopade. 2020 May;49(5):432–442.
  12. Neri T, Boyer B, Batailler C, et al. Dual mobility cups for total hip arthroplasty: tips and tricks. Sicot j. 2020;6:17.
  13. Sculco PK, Wright T, Malahias MA, et al. The Diagnosis and Treatment of Acetabular Bone Loss in Revision Hip Arthroplasty: An International Consensus Symposium. HSS J. 2022 Feb;18(1):8–41.
  14. Yu R, Hofstaetter JG, Sullivan T, et al. Validity and reliability of the Paprosky acetabular defect classification. Clin Orthop Relat Res. 2013 Jul;471(7):2259–2265.
  15. Babis GC, Nikolaou VS. Pelvic discontinuity: a challenge to overcome. EFORT Open Rev. 2021 Jun;6(6):459–471.
  16. Gozzard C, Blom A, Taylor A, et al. A comparison of the reliability and validity of bone stock loss classification systems used for revision hip surgery. J Arthroplasty. 2003 Aug;18(5):638–642.