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Background <p>Pelvic discontinuity is a rare but challenging condition in revision hip arthroplasty. Traditional reconstruction with anti-protrusio cages often lacks anterior support, providing no resistance against medial migration or implant protrusion, thereby potentially compromising long-term stability and implant longevity.</p> Methods <p>This retrospective study included 13 patients with intraoperatively confirmed pelvic discontinuity who underwent revision total hip arthroplasty between 2014 and 2023. Patients were divided into two groups: Group 1 (<i>n</i> = 8) received anti-protrusio cage reconstruction alone, while Group 2 (<i>n</i> = 5) underwent additional anterior quadrilateral surface plating prior to cage implantation. Clinical and radiological outcomes were assessed with a minimum follow-up of 2 years (mean: 6.3 years), including complications, loosening, and reoperation.</p> Results <p>Thirteen patients (mean age: 73.3 years) with intraoperatively confirmed pelvic discontinuity were included.Complication and reoperation rates were significantly higher in Group 1 (75%) compared to Group 2 (20%) (<i>p</i> &lt; 0.001). Kaplan–Meier analysis demonstrated superior complication-free survival in Group 2 (80% at 11 years) versus Group 1 (37.5% at 11 years). Periprosthetic fracture rates did not differ significantly (<i>p</i> = 0.21).</p> Conclusion <p>Preliminary results suggest that the addition of quadrilateral surface plating may enhance construct stability and reduce complications. Further studies with larger cohorts and biomechanical validation are warranted.</p>

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Quadrilateral surface plating combined with anti-protrusio cage for pelvic discontinuity—a preliminary clinical comparison of a novel technique

  • 期刊论文

  • 发表日期：

    2025年10月17日

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  • Mehmet Suleyman Abul,
  • Muzaffer Agir,
  • Omer Faruk Sevim,
  • Engin Eceviz,
  • İbrahim Tuncay

摘要

Background

Pelvic discontinuity is a rare but challenging condition in revision hip arthroplasty. Traditional reconstruction with anti-protrusio cages often lacks anterior support, providing no resistance against medial migration or implant protrusion, thereby potentially compromising long-term stability and implant longevity.

Methods

This retrospective study included 13 patients with intraoperatively confirmed pelvic discontinuity who underwent revision total hip arthroplasty between 2014 and 2023. Patients were divided into two groups: Group 1 (n = 8) received anti-protrusio cage reconstruction alone, while Group 2 (n = 5) underwent additional anterior quadrilateral surface plating prior to cage implantation. Clinical and radiological outcomes were assessed with a minimum follow-up of 2 years (mean: 6.3 years), including complications, loosening, and reoperation.

Results

Thirteen patients (mean age: 73.3 years) with intraoperatively confirmed pelvic discontinuity were included.Complication and reoperation rates were significantly higher in Group 1 (75%) compared to Group 2 (20%) (p < 0.001). Kaplan–Meier analysis demonstrated superior complication-free survival in Group 2 (80% at 11 years) versus Group 1 (37.5% at 11 years). Periprosthetic fracture rates did not differ significantly (p = 0.21).

Conclusion

Preliminary results suggest that the addition of quadrilateral surface plating may enhance construct stability and reduce complications. Further studies with larger cohorts and biomechanical validation are warranted.