Component migration is usually superomedially. Paprosky developed the classification evaluating patients. Acetabular defects were graded pre- operatively. Acetabular and Femoral Defect Classification* Acetabular Revision System . Paprosky W, Perona P, Lawrence J. Acetabular defect classification and. One commonly used classification is the Paprosky classification for femoral bone Type I femoral bone loss refers to a defect in which minimal . to more complex anatomic structures such as the acetabulum, the limitations of.

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The type of pain is important in that patients with start-up pain usually have loose components, and those with continuous unrelenting pain may be more likely to have an ongoing infection. Acetabular reconstructions with impacted morsellised cancellous bone graft and cement: These factors must be addressed in the planning process of the reconstruction and can be completed in such a way that the likelihood of success is optimized.


Particulate bone graft can be placed medially to lateralize the hip center of rotation back to its anatomic position. Biomaterials 30 Migration of aaoss component occurs superior and lateral because the acetabular rim is deficient. Results at a mean follow-up of 8. Figure A, Type 3A acetabular defect.

Classifications In Brief: Paprosky Classification of Acetabular Bone Loss

J Bone Joint Surg Am. Type IIIA defects demonstrate incomplete destruction of the teardrop medial wall of the teardrop present and it clasxification completely obliterated in type IIIB defects.


Despite poor reliability of the Paprosky classification on plain radiography, it remains useful because of its widespread use and the reconstruction guideline it provides. Clin Orthop Relat Res ; The ideal classification system should be simple to use and should have excellent intraobserver and interobserver reliability and validity.

Biological therapy of bone defects: A hemispherical cementless implant is almost completely supported by native bone; however, a large cup may be required. Figure AType 2C acetabular defect. Patients with a type 3B defect are at high risk for pelvic discontinuity; this possibility must be thoroughly evaluated at the time of reconstruction.

History and clinical assessment. Expert Opin Biol Ther. Cancellous screw or reconstruction plate outside acetabulum. Pelvic discontinuity is classified as type V.

Classifications In Brief: Paprosky Classification of Acetabular Bone Loss

Currently, we use a posterolateral approach to the hip for all acetabular revisions. Type 3A defects Fig. This aetabular is classified as a type IIC. Bone graft substitutes can be used in isolation or in combination with auto- or allograft. Discussion should include information on postoperative weight-bearing status and limitations, along with long-term outcome expectations. Often the position of optimal stability provided by remaining bone does not correlate with the optimal hip centre position.


The teardrop is present medial wall uninvolved and there is no ischial bone lysis posterior wall present.

Revision total hip arthroplasty: addressing acetabular bone loss

In these cases a stable pseudoarthrosis develops and reasonable outcomes have been reported 68,69 Limb shortening and instability are the concerns if a Girdlestone procedure is performed in cases of severe bone loss.

Superior migration of less than 2 cm is classified as a type II clasdification. J Am Acad Orthop Surg.

Superior and lateral migration indicates greater involvement of the posterior column. Revision surgery with femoral head and polyethylene exchange and retroacetabular bone grafting. Acehabular rim is enlarged and the medial wall is destroyed.

Wheeless’ Textbook of Orthopaedics

The saddle prosthesis for salvage of the destroyed acetabulum. Even with meticulous pre-operative planning, the final assessment of defectts and location of bone loss is often made intra-operatively and reconstruction performed accordingly.

Partial destruction of the teardrop is seen, but the medial limb usually is still present. Projections of primary and revision hip and knee arthroplasty in the United States from to

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