الفهرس 
Applied surgical anatomy of the acetabulumOnly 14 pages are availabe for public view
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Abstract
Bone deficiency in the acetabulum can be encountered in primary and revision acetabular reconstruction. Primary deficiencies result from either an abnormality of growth or a condition that alters the shape of the acetabulum . Bone deficiencies encountered during revision arthroplasty continue to be the most common.
Management of acetabular deficiency in total hip arthroplasty can be extremely challenging. A successful outcome requires good orientation about applied surgical anatomy of the acetabulum, careful preoperative planning, identification of complex defects, and stable reconstruction. Acetabular deficiencies are classified according to clinical radiographs, anticipated bone loss during removal of implants, and intraoperative assessment of host bone stock .
Many classification schemes have been formulated to describe acetabular deficiencies. The most commonly used schemes are those that are easy to remember, easy to reproduce, and are most useful in guiding treatment options.The classification specifically guides the use of bone graft and implants in revision acetabular reconstruction.
The primary goal is to obtain stable fixation to host bone. Secondary goals are to restore the hip center of rotation to its normal location, reconstitute bone stock, and restore leg-length discrepancies.
Magnitude and location of acetabular bone defects dictate the type of reconstruction required Management principles include the use of structural bone graft and/or reconstruction cage devices in acetabular revisions with major bone loss has the advantages of providing a stable construct at the anatomical hip center of rotation and, theoretically, reconstituting bone stock. When the structural graft supports more than 50% of the acetabular component, a reconstruction cage device spanning ilium to ischium should be used to protect the graft and provide structural stability.
Acetabular reconstruction in revision total hip arthropl-asty can successfully be achieved with hemispherical components featuring a porous or roughened ingrowth surface and options for placement of multiple screws. Most defects can be reconstructed with large hemispherical or ”jumbo” cups. Defects with greater bony loss or compromised columns require either the use of modular augments combined with a hemispherical shell, reconstruction cages, structural allografts, or custom triflange acetabular components .