Cic edizioni internazionali
Clinical Cases in mineral and bone metabolism

Revision surgery for acetabular nonunion: role and challenges to preservation of hip joint

Original Article, 416 - 422
Tag this article
Abstract
Full text PDF
Introduction. The non-union of the acetabulum is a very frequent complication in the Letournel classified associated fractures which involve mainly the posterior column.
Both the diagnosis and the treatment are very difficult. In this short work we are presenting the revisitation of our case histories of 21 acetabular nonunions.
Material. The study population is divided in 13 males and 8 females with an average age of 47.6 years (range 22-75).
The diagnosis of nonunion was made at about 5.2 months (3-6) after surgery. In 16 cases the nonunion was due to the conservative treatment and in 5 cases to surgery. All of then were Letournel classified associated fractures. All patients underwent revision surgery with plates and screws and implant of allogenic bone splints and autogenic morcelized bone taken from the iliac crest, after about 2.3 weeks (1-3) from the diagnosis of acetabular nonunions. The chosen criteria for patient assessment, during clinical and radiological follow-ups were: quality of life measured with the Short Form (12) Health Survey (SF-12), the functionality of the hip and quality of life measured with the Harris Hip Score (HHS) and by the Majeed Score (MJ), bone healing and post surgery complications.
Results. All patients showed a relative increase of the SF-12, HHS, MJ scores after revision surgery. On average, all patients manifested heterotopic ossification and hip arthrosis within 24 months after revision surgery. All patients within 24 months from the revision surgery received total hip prosthesis. Only 1 patient manifested an infection after the PTA.
Conclusion. The acetabular nonunions, although rare, represent a devastating complication for the patient’s quality of life and the revision surgery. Revision surgery, unfortunately, does not offer great satisfaction in the functional recovery and long-term quality of life, but has to allow an anatomic dignity of the acetabulum and a subsequent prosthetization in safety of these patients.

Vol. XV (No. 3) 2018 September - December

  1. From the Editor-in-Chief
    Brandi M.L.
  2. Effect on Trabecular Bone Score (TBS) of Tissue-Selective Estrogen Complex (TSEC) in early post-menopausal women: case report
    Lello S., Capozzi A., Scambia G.
  3. Sport and physical activity in patients with hereditary multiple exostoses
    D'Ambrosi R., Caldarini C., Massari G., Facchini R.M., Ragone V.
  4. Underdiagnosis of osteoporosis in different ethnic groups when bone mineral density is measured in a single area
    Mastaglia S.R., Bagur A., Mautalen C.A.
  5. Approach in aromatase inhibitors - induced osteoporosis: results from an Italian multicenter observational study
    Migliaccio S., de Sire A., Marocci C., Fornari R., Paoletta M., Greco E.A., Amar I.D., Moretti A., Ronzoni S., Gimigliano F., Vinicola V., Chiacchiararelli F., Guadalascara F., Pastore R., Falaschi P., Minisola G., Falla O., Castellitto D., Lenzi A., Villa P., Iolascon G.
  6. The clinical safety and possibility of immediate implant placement in aggressive periodontitis patients in maxillary esthetic zone: an empty systematic review
    Yussif N.M., Rahman A.R.A., Darhous M.
  7. Bilateral atypical femoral fractures in macroprolactinoma with hypopituitarism: a case report
    Charoensri S., Pongchaiyakul C.
  8. Spinal deformities in neurofibromatosis type 1
    Lykissas M.G., Mavrogenis A.F., Megaloikonomos P.D., Gelalis I.D., Lykomitros V.
  9. Treatment of osteoarthritis: focus on glucosamine
    Rovati L.C.
  10. Refractory hypercalcemia after idiopathic rhabdomyolysis
    Rodríguez-Quintero J.H., Ramos-Pineda A., Salas-Villela R., Gotés-Palazuelos J.
  11. Severe scoliosis in a Colombian patient with childhood hypophosphatasia
    Zarante Bahamón A.M.
  12. Teriparatide in cervical fracture consolidation
    Cordeiro Albino C., Porcelli Savarani C., Aguiar Moreira C.
  13. Incidental finding of osteopetrosis complicated with osteomyelitis
    Ibrahim A.K., Sansare K., Karjodkar F.R:
  14. Hungry bone syndrome presenting as pathological fracture in a young boy
    Chandra A., Hussain Z., Prasad Assat R., Chandra Meena R.
  15. Rare multifocal eosinophilic granuloma involving maxilla and mandible. A case report
    Shawky Shaker I., Salah Mohamed N.
  16. Teriparatide treatment for an atypical femoral fracture in a patient with calcinosis cutis associated with juvenile dermatomyositis: a case report
    Yoshitani J., Kabata T., Yamamoto N., Shimizu M., Kajino Y, Takagi T., Ohmori T., Ueno T., Tsuchiya H.
  17. Surgical approach to rare case of recurrent pheochromocytoma and bones metastatic paraganglioma
    Cosseddu F., Sacchetti F., Shytaj S., Grossi S., Citarelli C., De Gori M., D'Arienzo A., Capanna R.
  18. Mazabraud’s syndrome: a case report
    Ramírez Stieben R. S., Lifton S.
  19. A case of hypercalcemic parathyroid crisis in a patient with normocalcemic hyperparathyroidism
    Lithgow K., Pasieka J., Kline G.
  20. A Platelet Rich Plasma (PRP) and bovine xenograft combination placed in a jaw bone defect after surgical removal of a compound odontoma associated with an impacted lower canine using piezoelectric surgery: a case report
    Ayoub Al-Delayme R.M.
  21. Pharmacological therapy of sarcopenia: past, present and future
    Iolascon G., Moretti A., de Sire A., Liguori S., Toro G., Gimigliano F.
  22. Revision surgery for acetabular nonunion: role and challenges to preservation of hip joint
    Rollò G., Meccariello L., Bisaccia M., Pichierri P., Filipponi M., Giaracuni M., Di Giacomo L.M., Zinghì G.
  23. Reliability and value of external modular fixation (Hoffmann II®) in the management of humeral shaft fracture
    Bisaccia M., Meccariello L., Rinonapoli G., Ibáñez-Vicente C., Ribes-Iborra J., Gomez-Garrido D., Rollo G., Falzarano G., Shahid Khan M., Grubor P., Caraffa A.
Last Viewed articles: la lista degli ultimi x visitati.
  1. Revision surgery for acetabular nonunion: role and challenges to preservation of hip joint
    Rollò G., Meccariello L., Bisaccia M., Pichierri P., Filipponi M., Giaracuni M., Di Giacomo L.M., Zinghì G.
credits