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- Title
Revision surgery for acetabular nonunion: role and challenges to preservation of hip joint.
- Authors
Rollo, Giuseppe; Meccariello, Luigi; Bisaccia, Michele; Pichierri, Paolo; Filipponi, Marco; Giaracuni, Marco; Pellegrino, Marco; Di Giacomo, Lorenzo Maria; Zinghi, Gianfranco
- Abstract
Introduction. The non-union of the acetabulum is a very frequent complication in the Letournel classified associated fractures which involve mainly the posterior column. Both the diagnosis and the treatment are very difficult. In this short work we are presenting the revisitation of our case histories of 21 acetabular nonunions. Material. The study population is divided in 13 males and 8 females with an average age of 47.6 years (range 22-75). The diagnosis of nonunion was made at about 5.2 months (3-6) after surgery. In 16 cases the nonunion was due to the conservative treatment and in 5 cases to surgery. All of then were Letournel classified associated fractures. All patients underwent revision surgery with plates and screws and implant of allogenic bone splints and autogenic morcelized bone taken from the iliac crest, after about 2.3 weeks (1-3) from the diagnosis of acetabular nonunions. The chosen criteria for patient assessment, during clinical and radiological follow-ups were: quality of life measured with the Short Form (12) Health Survey (SF- 12), the functionality of the hip and quality of life measured with the Harris Hip Score (HHS) and by the Majeed Score (MJ), bone healing and post surgery complications. Results. All patients showed a relative increase of the SF-12, HHS, MJ scores after revision surgery. On average, all patients manifested heterotopic ossification and hip arthrosis within 24 months after revision surgery. All patients within 24 months from the revision surgery received total hip prosthesis. Only 1 patient manifested an infection after the PTA. Conclusion. The acetabular nonunions, although rare, represent a devastating complication for the patient's quality of life and the revision surgery. Revision surgery, unfortunately, does not offer great satisfaction in the functional recovery and long-term quality of life, but has to allow an anatomic dignity of the acetabulum and a subsequent prosthetization in safety of these patients.
- Subjects
SAN Francisco (Calif.); REOPERATION; ACETABULUM (Anatomy); HIP joint; SURGICAL complications; UNITED States. Dept. of Health &; Human Services. Office of Inspector General; ARTIFICIAL hip joints; HETEROTOPIC ossification
- Publication
Clinical Cases in Mineral & Bone Metabolism, 2018, Vol 15, Issue 3, p416
- ISSN
1724-8914
- Publication type
Article