Method of Acetabular Bone Defects Reconstruction for the Total Hip Joint Endoprosthetics

Armen Aivazyan

There is a 3 types of insolvent bone couch for the endoprosthetics acetabular cup: dysplastic -in case of defect of the acetabular development, degenerative-dystrophic - coxarthrosis, osteoporosis and operative-complicated - jatrogenic such as intraoperative produced acetabular fracture. This conditions may cause such complications as: acetabular lousening, dislocation of cup and protrusion of acetabular cup. There are 3 types of reconstructions of acetabulum: 1. Roof-cage reinforcement - in case of insolvent bottom it's used stacking of bone chips from bone of resected during arthroplasty procedure femoral head, then the roof-cage is seated on place and finaly the bone cement is filled and the cup is implanted; this method is not to be uses for the dysplasy, because there is not the bone defect presence, but the defect of the geometric configuration (flattening, insolvent depth or flattened-eliptical configuration). 2. Heavy mesh-cage reinforcement - in case of the acetabular dysplasy or of acetabular roof deficiency the reconstruction is apply, or the plasty of roof; the femoral head autograft reinforced heavy mesh-cage, which screwed in bone, is used for bone deficit covering; after the standard cup replacement is performed. 3. Acetabular roof-plasty with bone transplants - in cases when needed no to reinforce acetabulum, it was enough to make the acetabuloplasty with the femoral head autograft; the roof is maked of transplant, then the reamering is performed for the new acetabular cavity forming, finaly the cemented or cementless cup is implanted.

Keywords:   endoprosthetics, reconstruction, hip joint