templating done by Dr. kattab who is my colleague
The two independent screws were intraarticular transfixing the head which had to osteotomised in situ. and a primary ceramic on ceramic hip was done. introp frozen section and cultures were taken/
1 . retained implants
2.infection
3.deformed acetabulum
3.nonunion with dissociation or resorption
4.cavitatory or segmental defects
5.HO
6.neurological deficit
7. Impaired musculature
if you asses the results one can find the following
symptomatic acetabular loosening is higher
uncemented cups do better at medium term.
neurological defecits, HO are higher. Cavitatory defect can be filled with morcelised bone grafts and impacted or reverse reamed. Majority host bone contact should be at least 70 percent if possible specially in the wt bearing zone. Avoid large grafts as they do not revascualrise completely and might fail in the medium term. In case of dissociation cage cup combo bypassing the defect would give reasonable 10 year results. Recently distraction of the dissociation stabilized by cup reinforced by cage and a cemented cup has been proposed and published by paprosky
