Rationale for the use of the original classification of posttraumatic acetabular deformities in primary total hip replacement
Abstract. Introduction Analysis of publications on primary hip replacement shows lower survival rates in patients with acetabular injuries. With the lack of a unified system for assessing post-traumatic acetabular deformities, authors tend to use the available classifications of acute pelvic trauma...
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| Autores principales: | , , , , , |
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| Formato: | article |
| Lenguaje: | EN RU |
| Publicado: |
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/f24926023648411395261daff52f3d5f |
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| Sumario: | Abstract. Introduction Analysis of publications on primary hip replacement shows lower survival rates in patients with acetabular injuries. With the
lack of a unified system for assessing post-traumatic acetabular deformities, authors tend to use the available classifications of acute pelvic trauma (AO/
ASIF, Young & Burgess, Tile, etc.) and acetabular osteolysis (AAOS, DGOT, Gross and Saleh, Paprosky), which we think can be inappropriate with the
classifying systems meant for different patterns of acetabular deficiency. Material and methods CT scans of 117 patients with posttraumatic acetabular
deformities were reviewed prior to total hip replacement (THR) performed for posttraumatic grade III coxarthrosis. The displacement of acetabular
walls was determined with the measurements tabulated and analyzed. Results An original "ASPID" classification of post-traumatic deformities based
on the findings obtained was offered with use of three assessment criteria: localization of the deformity, extent of displacement and the integrity of the
pelvic ring. The ASPID classification can be used for the localization of the deformity with anterior (A), superior (S), posterior (P) and inner acetabular
walls (I) to be identified. Measurements of displacement ranging 0-5 mm suggests grade 0 displacement; 6-15 mm, grade 1 displacement and greater
than 15 mm, grade 2 displacement. The integrity of the pelvic ring evaluated from the involvement side as D0 suggests maintained pelvic integrity and
D1, broken pelvic integrity. An acetabular hardware would be marked with 'H'. Conclusion ASPID classification is easy to use and has shown to be
practical for planning of primary THR after acetabular fracture. |
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