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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

A further 3-D reconstruction and scrolling throughout allslices allows the surgeon to clearly rule out a complete bracing ofthe hook around the urether.
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Figure 5: A further 3-D reconstruction and scrolling throughout allslices allows the surgeon to clearly rule out a complete bracing ofthe hook around the urether.

Mentions: The initial conventional CT-scan revealed the close proximity of the anchoring hook to the urethra, consequently a continuative contrast agent based CT scan was performed. which demonstrated the urethra looped around the hook of the reinforcement ring. No other relevant soft tissue encroachment was noted and an appropriate pre-operative plan was performed accordingly (Figs. 4, 5).


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)

A further 3-D reconstruction and scrolling throughout allslices allows the surgeon to clearly rule out a complete bracing ofthe hook around the urether.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: A further 3-D reconstruction and scrolling throughout allslices allows the surgeon to clearly rule out a complete bracing ofthe hook around the urether.
Mentions: The initial conventional CT-scan revealed the close proximity of the anchoring hook to the urethra, consequently a continuative contrast agent based CT scan was performed. which demonstrated the urethra looped around the hook of the reinforcement ring. No other relevant soft tissue encroachment was noted and an appropriate pre-operative plan was performed accordingly (Figs. 4, 5).

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