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Importance of preoperative imaging in acetabular revision surgery - a case report.

Schmitz H, Egidy C, Al-Khateeb H, Cárdenas G, Gehrke T, Kendoff D - Open Orthop J (2012)

Bottom Line: Potential complications include injury of nerves, blood vessels and other intrapelvic structures.In our case, a major bony defect of the acetabulum was a result of the protrusion of an implanted reinforcement ring.A preoperative, contrast-enhanced CT scan showed that the urethra was in close proximity to the hook of the reinforcement ring.The preoperative imaging aided in identifying and understanding the potential complications that could occur intraoperatively.Additionally, it delineated the intact anatomic structures prior to surgery, which could have medico-legal implications.The importance of preoperative imaging and the existing literature is discussed within this case description.

View Article: PubMed Central - PubMed

Affiliation: ENDO-Klinik Hamburg, Helios Group, Holstenstraße 9, 22767 Hamburg, Germany.

ABSTRACT
Acetabular defects, particularly as a result of protrusion of acetabular components into the hemipelvis, may cause serious complications during revision procedures as a result of iatrogenic injury to surrounding anatomical structures. In these challenging cases, we advocate the utilisation of preoperative three dimensional imaging. MRI and CT- imaging offer superior understanding of the three-dimensional quality of bony defects and the relationship of implants to important anatomical structures. Appropriate preoperative planning may also prevent major complications during the removal of the pre-existing hardware, prior to re-implantation of implants. Potential complications include injury of nerves, blood vessels and other intrapelvic structures.In our case, a major bony defect of the acetabulum was a result of the protrusion of an implanted reinforcement ring. A preoperative, contrast-enhanced CT scan showed that the urethra was in close proximity to the hook of the reinforcement ring.The preoperative imaging aided in identifying and understanding the potential complications that could occur intraoperatively. Additionally, it delineated the intact anatomic structures prior to surgery, which could have medico-legal implications.The importance of preoperative imaging and the existing literature is discussed within this case description.

No MeSH data available.


Related in: MedlinePlus

Pelvis AP identifying the migration of the reinforcementhook into the pelvis.
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Figure 1: Pelvis AP identifying the migration of the reinforcementhook into the pelvis.

Mentions: Plain radiographs demonstrated the protrusion of the reinforcement ring into the pelvis and complete migration of the anchoring hook into the pelvis with close proximity to the anatomic structures and other major soft tissue structures. There was no evidence of stem loosening or migration noted (Figs. 1, 2). Based on these findings and particularly the position of the anchoring hook and close proximity to intrapelvic structures, a CT scan was performed (Fig. 3).


Importance of preoperative imaging in acetabular revision surgery - a case report.

Schmitz H, Egidy C, Al-Khateeb H, Cárdenas G, Gehrke T, Kendoff D - Open Orthop J (2012)

Pelvis AP identifying the migration of the reinforcementhook into the pelvis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3367474&req=5

Figure 1: Pelvis AP identifying the migration of the reinforcementhook into the pelvis.
Mentions: Plain radiographs demonstrated the protrusion of the reinforcement ring into the pelvis and complete migration of the anchoring hook into the pelvis with close proximity to the anatomic structures and other major soft tissue structures. There was no evidence of stem loosening or migration noted (Figs. 1, 2). Based on these findings and particularly the position of the anchoring hook and close proximity to intrapelvic structures, a CT scan was performed (Fig. 3).

Bottom Line: Potential complications include injury of nerves, blood vessels and other intrapelvic structures.In our case, a major bony defect of the acetabulum was a result of the protrusion of an implanted reinforcement ring.A preoperative, contrast-enhanced CT scan showed that the urethra was in close proximity to the hook of the reinforcement ring.The preoperative imaging aided in identifying and understanding the potential complications that could occur intraoperatively.Additionally, it delineated the intact anatomic structures prior to surgery, which could have medico-legal implications.The importance of preoperative imaging and the existing literature is discussed within this case description.

View Article: PubMed Central - PubMed

Affiliation: ENDO-Klinik Hamburg, Helios Group, Holstenstraße 9, 22767 Hamburg, Germany.

ABSTRACT
Acetabular defects, particularly as a result of protrusion of acetabular components into the hemipelvis, may cause serious complications during revision procedures as a result of iatrogenic injury to surrounding anatomical structures. In these challenging cases, we advocate the utilisation of preoperative three dimensional imaging. MRI and CT- imaging offer superior understanding of the three-dimensional quality of bony defects and the relationship of implants to important anatomical structures. Appropriate preoperative planning may also prevent major complications during the removal of the pre-existing hardware, prior to re-implantation of implants. Potential complications include injury of nerves, blood vessels and other intrapelvic structures.In our case, a major bony defect of the acetabulum was a result of the protrusion of an implanted reinforcement ring. A preoperative, contrast-enhanced CT scan showed that the urethra was in close proximity to the hook of the reinforcement ring.The preoperative imaging aided in identifying and understanding the potential complications that could occur intraoperatively. Additionally, it delineated the intact anatomic structures prior to surgery, which could have medico-legal implications.The importance of preoperative imaging and the existing literature is discussed within this case description.

No MeSH data available.


Related in: MedlinePlus