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MECHANICAL COMPARISON OF ACETABULAR REVISION CONSTRUCTS FOR THE TREATMENT OF PELVIC DISCONTINUITY

INTRODUCTION Pelvic discontinuity is a severe form of acetabular deficiency in revision total hip arthroplasty in which there is complete separation of the superior and inferior hemipelvis. It remains one of the most difficult problems in acetabular reconstruction. Before the hip joint can be reconstructed, the pelvic discontinuity is bone grafted then bridged and stabilized with a revision construct. Excessive motion at the discontinuity may jeopardize the bone graft’s ability to achieve bony union, leading to failure of the reconstruction. Current options to mechanically stabilize pelvic discontinuity include porous coated cups with posterior column plating and various reconstruction cages with cemented polyethylene cups. It is suggested that posterior column plating in addition to reconstruction cages may further reduce micromotion. The benefits of this added stability, however, may or may not outweigh the risks associated with more extensive surgery. These revision strategies have been clinically reported and have met with varied success. The purpose of this study was to mechanically test and compare the initial stability of several acetabular revision construct strategies, with and without posterior column plating, to determine which best reduced micromotion.