Treatment of Acetabular Segmental Deficits (3)

MANAGEMENT OF SEGMENTAL ACETABULAR DEFICIT (FLETCHER)

■ Ream the native acetabulum in 1-mm increments until two points of fixation are found.

■ Place an acetabular trial one size larger than the last reamer and assess stability.

■ If stability is questionable, use acetabular augments to improve stability by filling bony defects.

■ Using trial augments as a guide for sizing the defect, ream the defect line-to-line to accommodate the augment, while minimizing host bone removal.

■ Place the definitive augment in the defect and fix it with 6.5-mm screws to host bone. Cancellous allograft can then be packed into the voids in the augment and inremaining cavitary defects (Fig. 3-160).

■ Place doughy cement at the interface of the augment and acetabular component, and impact the acetabular component into position.

■ Use multiple screws through the acetabular shell into host bone to provide stability to the entire construct. 

Note: this article comes from CAMPBELL’S OPERATIVE ORTHOPAEDICS by S. Terry Canale James H. Beaty.