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Defining the canal for ischial and pubic screws in cup revision surgery
PURPOSE: When revising acetabular cups, it is often necessary to provide additional stabilisation with screws. In extensive defect situations, the placement of screws caudally in the ischium and/or pubis is biomechanically advantageous. Especially after multiple revision operations, the surgeon is c...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9556370/ https://www.ncbi.nlm.nih.gov/pubmed/35994066 http://dx.doi.org/10.1007/s00264-022-05552-5 |
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author | Brodt, Steffen Boersch, Vincent Strube, Patrick Wassilew, Georgi Matziolis, Georg |
author_facet | Brodt, Steffen Boersch, Vincent Strube, Patrick Wassilew, Georgi Matziolis, Georg |
author_sort | Brodt, Steffen |
collection | PubMed |
description | PURPOSE: When revising acetabular cups, it is often necessary to provide additional stabilisation with screws. In extensive defect situations, the placement of screws caudally in the ischium and/or pubis is biomechanically advantageous. Especially after multiple revision operations, the surgeon is confronted with a reduced bone stock and unclear or altered anatomy. In addition, screw placement caudally is associated with greater risk. Therefore, the present study aims to identify and define safe zones for the placement of caudal acetabular screws. METHODS: Forty-three complete CT datasets were used for the evaluation. Sixty-three distinctive 3D points representing bone landmark of interests were defined. The coordinates of these points were then used to calculate all the parameters. For simplified visualisation and intra-operative reproducibility, an analogue clock was used, with 12 o’clock indicating cranial and 6 o’clock caudal. RESULTS: A consistent accumulation was found at around 4.5 ± 0.3 hours for the ischium and 7.9 ± 0.3 hours for the pubic bone. CONCLUSIONS: The anatomy of the ischium and pubis is sufficiently constant to allow the positioning of screws in a standardised way. The interindividual variation is low — regardless of gender — so that the values determined can be used to position screws safely in the ischium and pubis. The values determined can provide the surgeon with additional orientation intra-operatively when placing caudal acetabular screws. |
format | Online Article Text |
id | pubmed-9556370 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-95563702022-10-14 Defining the canal for ischial and pubic screws in cup revision surgery Brodt, Steffen Boersch, Vincent Strube, Patrick Wassilew, Georgi Matziolis, Georg Int Orthop Original Paper PURPOSE: When revising acetabular cups, it is often necessary to provide additional stabilisation with screws. In extensive defect situations, the placement of screws caudally in the ischium and/or pubis is biomechanically advantageous. Especially after multiple revision operations, the surgeon is confronted with a reduced bone stock and unclear or altered anatomy. In addition, screw placement caudally is associated with greater risk. Therefore, the present study aims to identify and define safe zones for the placement of caudal acetabular screws. METHODS: Forty-three complete CT datasets were used for the evaluation. Sixty-three distinctive 3D points representing bone landmark of interests were defined. The coordinates of these points were then used to calculate all the parameters. For simplified visualisation and intra-operative reproducibility, an analogue clock was used, with 12 o’clock indicating cranial and 6 o’clock caudal. RESULTS: A consistent accumulation was found at around 4.5 ± 0.3 hours for the ischium and 7.9 ± 0.3 hours for the pubic bone. CONCLUSIONS: The anatomy of the ischium and pubis is sufficiently constant to allow the positioning of screws in a standardised way. The interindividual variation is low — regardless of gender — so that the values determined can be used to position screws safely in the ischium and pubis. The values determined can provide the surgeon with additional orientation intra-operatively when placing caudal acetabular screws. Springer Berlin Heidelberg 2022-08-22 2022-11 /pmc/articles/PMC9556370/ /pubmed/35994066 http://dx.doi.org/10.1007/s00264-022-05552-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper Brodt, Steffen Boersch, Vincent Strube, Patrick Wassilew, Georgi Matziolis, Georg Defining the canal for ischial and pubic screws in cup revision surgery |
title | Defining the canal for ischial and pubic screws in cup revision surgery |
title_full | Defining the canal for ischial and pubic screws in cup revision surgery |
title_fullStr | Defining the canal for ischial and pubic screws in cup revision surgery |
title_full_unstemmed | Defining the canal for ischial and pubic screws in cup revision surgery |
title_short | Defining the canal for ischial and pubic screws in cup revision surgery |
title_sort | defining the canal for ischial and pubic screws in cup revision surgery |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9556370/ https://www.ncbi.nlm.nih.gov/pubmed/35994066 http://dx.doi.org/10.1007/s00264-022-05552-5 |
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