Pelvic Discontinuity Associated With Total Hip Arthroplasty

Evaluation and Management

Matthew P. Abdel, MD; Robert T. Trousdale, MD; Daniel J. Berry, MD

Disclosures

J Am Acad Orthop Surg. 2017;25(5):330-338. 

In This Article

Summary

Pelvic discontinuity is challenging to manage. The surgeon must attempt to obtain long-term acetabular component stability while simultaneously creating an environment conducive to healing of the discontinuity or healing that unitizes the pelvis. Achieving long-term cup stability is difficult because of potential motion between the superior and inferior pelvis and notable concurrent bone loss that frequently accompanies pelvic discontinuity. Healing of pelvic discontinuity is also challenging because of the technical difficulties of gaining rigid fixation across an area with notable bone loss and limited biologic healing potential resulting from dysvascularity related to previous procedures. The most successful treatment options are those with high rates of cup fixation and simultaneous pelvic discontinuity healing or unitization.

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