ACETABULAR
ROOF RECONSTRUCTION
Joseph Schatzker, M.D.,
B.Sc (Meds) F.R.C.S.(C) Professor, University of
Toronto Orthopaedic Surgeon Sunnybrook Hospital &
Women’s Health Science Centre Toronto,Ontario Summary: The acetabular roof ring and antiprotrusio cage are used to protect bone grafts and restore normal acetabular biomechanics. They depend on press fit and screws for fixation. The polyethylene cup is cemented into them. The
roof rings are used for small cavitatory defects, osteoporosis or acetabular
dysplasia. The antiprotrusio cages are used for major cavitatory and
segmental defects, pelvic discontinuity and global acetabular deficiency. 95 out of the 123 patients who required acetabular
roof reconstruction were for revision total hip arthroplasty. The follow-up
was from 1-16 years with a mean of 6.5 years. 57 patients had acetabular roof
rings while 38 patients had antiprotrusio cages. Of the revisions, 91% were
for aseptic loosening, 3% for septic loosening, 3% for broken implants and 3%
for girdlestones. 15% had previous stem and acetabular revisions and 8%
previous acetabular revisions alone. At 13 years, 14.7% acetabular roof rings and 5.8%
antiprotrusio cages had failed. The average pre- and post-operative Harris
Hip Score was 43 and 85 for the acetabular roof rings and 47 and 83 for the
antiprotrusio cages. Evaluation by patients was 76% good to excellent for the
acetabular roof rings and 65% good to excellent for the antiprotrusion cages. The principle advantage of these devices is the
restoration of normal acetabular biomechanics and the major restoration of
lost acetabular bone. Indications for Acetabular Roof Reinforcement
Rings:
Indications
for Acetabular Reconstruction Cage:
Advantages of Acetabular Roof Reconstruction
Techniques:
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