Novel bicolumnar fixation with primary cup implantation for pelvic discontinuity in revision hip arthroplasty: a comparative clinical study.
6 affiliations
- 1Department of Orthopaedics and Traumatology, Baltalimanı Kemik Hastalıkları Hastanesi, Istanbul, Turkey.
- 2Department of Orthopaedics and Traumatology, Acıbadem University, Acıbadem Maslak Hospital, International Joint Center, Istanbul, Turkey. [email protected].
- 3Department of Orthopaedics and Traumatology, Çermik State Hospital, Diyarbakır, Turkey.
- 4Department of Orthopaedics and Traumatology, Dr. Lütfi Kırdar Şehir Hastanesi, Istanbul, Turkey.
- 5Department of Orthopaedics and Traumatology, St George's University Hospitals NHS Foundation Trust, London, UK.
- 6Department of Orthopaedics and Traumatology, Acıbadem University, Acıbadem Maslak Hospital, International Joint Center, Istanbul, Turkey.
Abstract
Background
Pelvic discontinuity is a rare but challenging condition in revision hip arthroplasty. Traditional cage-based reconstruction techniques often rely solely on mechanical fixation and may be associated with implant migration, loosening, and mechanical failure. Alternative strategies aimed at restoring pelvic continuity and achieving biological fixation may improve construct stability and clinical outcomes.Methods
This retrospective study included 19 patients with intraoperatively confirmed pelvic discontinuity who underwent revision total hip arthroplasty between 2014 and 2024. Patients were divided into three groups according to the reconstruction technique used: Group 1 (n = 8) underwent anti-protrusio cage reconstruction alone, Group 2 (n = 6) received additional anterior quadrilateral surface plating prior to cage implantation, and Group 3 (n = 5) underwent restoration of pelvic continuity through anterior and posterior column fixation followed by implantation of a porous-coated primary acetabular cup. Clinical and radiological outcomes were assessed with a minimum follow-up of 2 years, including complications, loosening, reoperation, and reoperation-free survival.Results
Nineteen patients (mean age 71.2 years) with intraoperatively confirmed pelvic discontinuity were included. Aseptic loosening rates differed significantly among the three groups (P = 0.039), occurring in 50% of patients in Group 1 and in none of the patients in Groups 2 or 3. Reoperation rates were higher in Group 1 (75%) than in Group 2 (16.7%) and Group 3 (20%), although this difference did not reach statistical significance (P = 0.074). Kaplan-Meier analysis demonstrated a trend toward lower reoperation-free survival in Group 1; however, differences among the groups were not statistically significant (log-rank P = 0.237).Conclusion
Reconstruction strategies involving restoration of pelvic continuity through column stabilization may provide improved mechanical stability and lower complication rates compared with conventional cage-only techniques in the management of pelvic discontinuity. In selected patients, bicolumnar fixation followed by implantation of a porous-coated primary acetabular cup may offer the additional advantage of biological fixation. Larger prospective studies are needed to validate these findings.
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BibTeX
@article{abul2026novel,
title = {{Novel bicolumnar fixation with primary cup implantation for pelvic discontinuity in revision hip arthroplasty: a comparative clinical study.}},
author = {Mehmet Süleyman Abul and Muzaffer Ağır and Hüsnü Yılmaz and Ömer Hekim and Ömer Faruk Sevim and İbrahim Tuncay},
journal = {Archives of orthopaedic and trauma surgery},
year = {2026},
month = oct,
doi = {10.1007/s00402-026-06424-y},
url = {https://europepmc.org/article/MED/42955382},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Novel bicolumnar fixation with primary cup implantation for pelvic discontinuity in revision hip arthroplasty: a comparative clinical study.
AU - Mehmet Süleyman Abul
AU - Muzaffer Ağır
AU - Hüsnü Yılmaz
AU - Ömer Hekim
AU - Ömer Faruk Sevim
AU - İbrahim Tuncay
PY - 2026
DA - 2026/10/29
JO - Archives of orthopaedic and trauma surgery
DO - 10.1007/s00402-026-06424-y
UR - https://europepmc.org/article/MED/42955382
AB - Background Pelvic discontinuity is a rare but challenging condition in revision hip arthroplasty. Traditional cage-based reconstruction techniques often rely solely on mechanical fixation and may be associated with implant migration, loosening, and mechanical failure. Alternative strategies aimed at restoring pelvic continuity and achieving biological fixation may improve construct stability and clinical outcomes.Methods This retrospective study included 19 patients with intraoperatively confirmed pelvic discontinuity who underwent revision total hip arthroplasty between 2014 and 2024. Patients were divided into three groups according to the reconstruction technique used: Group 1 (n = 8) underwent anti-protrusio cage reconstruction alone, Group 2 (n = 6) received additional anterior quadrilateral surface plating prior to cage implantation, and Group 3 (n = 5) underwent restoration of pelvic continuity through anterior and posterior column fixation followed by implantation of a porous-coated primary acetabular cup. Clinical and radiological outcomes were assessed with a minimum follow-up of 2 years, including complications, loosening, reoperation, and reoperation-free survival.Results Nineteen patients (mean age 71.2 years) with intraoperatively confirmed pelvic discontinuity were included. Aseptic loosening rates differed significantly among the three groups (P = 0.039), occurring in 50% of patients in Group 1 and in none of the patients in Groups 2 or 3. Reoperation rates were higher in Group 1 (75%) than in Group 2 (16.7%) and Group 3 (20%), although this difference did not reach statistical significance (P = 0.074). Kaplan-Meier analysis demonstrated a trend toward lower reoperation-free survival in Group 1; however, differences among the groups were not statistically significant (log-rank P = 0.237).Conclusion Reconstruction strategies involving restoration of pelvic continuity through column stabilization may provide improved mechanical stability and lower complication rates compared with conventional cage-only techniques in the management of pelvic discontinuity. In selected patients, bicolumnar fixation followed by implantation of a porous-coated primary acetabular cup may offer the additional advantage of biological fixation. Larger prospective studies are needed to validate these findings.
SN - 0936-8051
SN - 1434-3916
ER -