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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 2/2012

01-02-2012 | Symposium: Papers Presented at the Annual Meetings of The Hip Society

Pelvic Discontinuity Treated With Custom Triflange Component: A Reliable Option

Authors: Michael J. Taunton, MD, Thomas K. Fehring, MD, Paul Edwards, MD, Thomas Bernasek, MD, Ginger E. Holt, MD, Michael J. Christie, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2012

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Abstract

Background

Pelvic discontinuity is an increasingly common complication of THA. Treatments of this complex situation are varied, including cup-cage constructs, acetabular allografts with plating, pelvic distraction technique, and custom triflange acetabular components. It is unclear whether any of these offer substantial advantages.

Questions/purposes

We therefore determined (1) revision and overall survival rates, (2) discontinuity healing rate, and (3) Harris hip score (HHS) after treatment of pelvic discontinuity with a custom triflange acetabular component and (4) the cost of this reconstructive operation compared to other constructs.

Methods

We retrospectively reviewed 57 patients with pelvic discontinuity treated with revision THA using a custom triflange acetabular component. We reviewed operative reports, radiographs, and clinical data for clinical and radiographic results. We also performed a cost comparison with utilization of other techniques. Minimum followup was 24 months (average, 65 months; range, 24–215 months).

Results

Fifty-six of 57 (98%) were free of revision for aseptic loosening at latest followup. Fifty-four (95%) were free of revision of the triflange component for any reason. Thirty-seven (65%) were free of revision for any reason. Twenty-eight (49%) were free of revision for any reason and free of any component migration and had a healed discontinuity. Forty-six (81%) had a stable triflange component with a healed pelvic discontinuity. Average HHS was 74.8. The costs of the custom triflange implants and a Trabecular Metal® cup-cage construct were equivalent: $12,500 and $11,250, respectively.

Conclusions

In this group of patients with osteolytic pelvic discontinuity, triflange implants provided predictable mid-term fixation at a cost equivalent to other treatment methods.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Pelvic Discontinuity Treated With Custom Triflange Component: A Reliable Option
Authors
Michael J. Taunton, MD
Thomas K. Fehring, MD
Paul Edwards, MD
Thomas Bernasek, MD
Ginger E. Holt, MD
Michael J. Christie, MD
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-011-2126-1

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