John Antoniades1, Vincent D Pellegrini. 1. Department of Orthopaedics, University of Maryland School of Medicine, 3449 Wilkens Ave, Suite 107, Baltimore, MD 21229, USA. johnantoniades@yahoo.com
Abstract
BACKGROUND: High hip center reconstructions, used in revision and complex primary THAs, rely on pelvic bone stock at least 35 mm above the anatomic teardrop. However, the technique does not restore normal hip biomechanics and controversy exists regarding acetabular implant survival. Previous reports document a wide range of implant positioning above the teardrop. There is no anatomic guidance in the literature regarding the amount of bone stock available for initial implant stability in this area of the ilium. QUESTIONS/PURPOSES: We therefore determined the thickness of the human ilium and related it to acetabulum cup coverage in high hip center reconstructions. METHODS: We sectioned 16 cadaveric hips from the anterior superior iliac spine to the anatomic teardrop in 5-mm increments, then measured the thickness of the ilium for each cross section. RESULTS: The maximum thickness of 42 ± 9 mm occurred at the dome of the acetabulum 35 ± 3 mm above the teardrop. At a distance of 1 cm above the dome, the ilium was reduced by 24%, to 32 ± 6 mm. At 2 cm above the dome, the ilium thickness was 22 ± 4 mm, a 48% reduction from its maximum. CONCLUSION: There are substantial anatomic limitations to high hip reconstructions 2 cm above the acetabular dome.
BACKGROUND: High hip center reconstructions, used in revision and complex primary THAs, rely on pelvic bone stock at least 35 mm above the anatomic teardrop. However, the technique does not restore normal hip biomechanics and controversy exists regarding acetabular implant survival. Previous reports document a wide range of implant positioning above the teardrop. There is no anatomic guidance in the literature regarding the amount of bone stock available for initial implant stability in this area of the ilium. QUESTIONS/PURPOSES: We therefore determined the thickness of the human ilium and related it to acetabulum cup coverage in high hip center reconstructions. METHODS: We sectioned 16 cadaveric hips from the anterior superior iliac spine to the anatomic teardrop in 5-mm increments, then measured the thickness of the ilium for each cross section. RESULTS: The maximum thickness of 42 ± 9 mm occurred at the dome of the acetabulum 35 ± 3 mm above the teardrop. At a distance of 1 cm above the dome, the ilium was reduced by 24%, to 32 ± 6 mm. At 2 cm above the dome, the ilium thickness was 22 ± 4 mm, a 48% reduction from its maximum. CONCLUSION: There are substantial anatomic limitations to high hip reconstructions 2 cm above the acetabular dome.
Authors: T C Doehring; H E Rubash; F J Shelley; L J Schwendeman; T K Donaldson; Y A Navalgund Journal: J Arthroplasty Date: 1996-09 Impact factor: 4.757
Authors: Nikolaos A Christodoulou; Konstantinos P Dialetis; Athanasios N Christodoulou Journal: Clin Orthop Relat Res Date: 2010-01-05 Impact factor: 4.176
Authors: Jorge Rojas; Maria Bautista; Guillermo Bonilla; Omar Amado; Elina Huerfano; Daniel Monsalvo; Adolfo Llinás; José Navas Journal: Int Orthop Date: 2017-08-07 Impact factor: 3.075
Authors: Michael S Gruber; Michael Jesenko; Julia Burghuber; Josef Hochreiter; Peter Ritschl; Reinhold Ortmaier Journal: BMC Musculoskelet Disord Date: 2020-12-10 Impact factor: 2.362
Authors: Basilio De la Torre; Loreto Barrios; Juan De la Torre-Mosquera; Julia Bujan; Miguel A Ortega; Carlos González-Bravo Journal: Materials (Basel) Date: 2021-11-27 Impact factor: 3.623