Abstract
Background
The increasing amount of revision surgeries in total hip arthroplasty (THA) represents a burden for orthopedic surgeons given the complexity and unpredictability of this kind of surgery. The aim of the current study was to develop a new radiographic classification of acetabular bone defects stratify the severity of the lesion and to suggest the surgical strategy to address it.
Methods
Radiographs of 151 consecutive patients who underwent acetabular revision surgery in our institution were collected to develop a new classification that groups the acetabular bone defects in three zones (A, B and C). The performance to predict treatment and inter- and intra-rater agreement were evaluated.
Results
The ability of the newly proposed classification to predict treatment was 87.3% (k weighted: 0.65). The inter-rater reliability was 90.1% (k: 0.81), and the intra-rater reliability between the two sets of evaluations performed by the observer at 1-month distance was 97.5% (k: 0.94).
Conclusions
The newly proposed classification was able to characterize the extent of acetabular bone defects and predict pre-operatively the appropriate surgical treatment strategy in 87.3% of cases. It showed a strong agreement among raters and an almost perfect agreement among different measurements at 1 month distance. This new tool could be used in the preoperative assessment to drive the use of secondary level image examinations and the type of surgical management.
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G.G. declares Royalties and licenses from Zimmer Biomet, Innomed, and Adler Ortho; Financial support for attending symposia and educational programs from Zimmer Biomet. M.L. declares a Research grant (GR- 2018- 12367275) to IRCCS Humanitas Research Hospital from the Italian Ministry of Health and Research grants to Fondazione Livio Sciutto - ONLUS to perform postmarket study for medical devices from Zimmer Biomet.
E.G. and F.M.G. and F.L.C. and E.M. declare no conflict of interest.
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Loppini, M., Guazzoni, E., Gambaro, F.M. et al. A new classification to characterize and predict treatment of acetabular bone defects. Arch Orthop Trauma Surg (2024). https://doi.org/10.1007/s00402-024-05327-0
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DOI: https://doi.org/10.1007/s00402-024-05327-0