Intraoperative fracture during acetabular component removal
General considerations
Intraoperative fractures occurring during removal of the acetabular components are classified as Della Valle II. The fracture pattern can be simple or complex.
Type IIA patterns involves less than 50% of the acetabular bone stock. Type IIB involves more than 50% of the bone stock.
Further information about Della Valle classification can be found in the publication: Della Valle CJ, Momberger NG, Paprosky WG. Periprosthetic fractures of the acetabulum associated with a total hip arthroplasty. Instr Course Lect. 2003;52:281–290.
Etiology
- Loss of cup fixation, associated micromotion, cup migration
- Pelvic osteolysis
- Forceful or eccentric cup removal
- Incomplete screw removal prior to cup removal
Clinical signs
- Visible fracture lines and/or motion of fracture fragments
Imaging
- Visual inspection and recognition are sufficient
- Fluoroscopy or regular radiographs may further define the extent of the fracture patterns
