Compensation of acetabular defects in hip arthroplasty

Abstract

Acetabular reconstruction is a necessary condition for improving the survival rate and proper functioning of the implant. The issue of compensation for bone loss remains one of the most difficult and controversial in orthopaedics. The article aimed to analyze approaches to the problem of management of acetabular defects in hip replacement. The paper presents the key features of the anatomy and radiological anatomy of the acetabulum. Modern modifications of acetabular components of an endoprosthesis, their advantages and disadvantages, as well as ways to compensate for acetabular bone loss with bone substitute materials are considered. The review highlights the use of 3Dprinting technologies, the interaction between physicians and other experts in this field. Currently, an active search for materials, alternatives to autogenous bone, as well as ways to facilitate the design and reduce the negative impact of the implant on the patient's bone tissue continues. The use of additive technologies seems to be the most promising direction that allows applying an individual approach to each clinical case, but it is available only in specialized centres and is associated with significant material, technical and legal difficulties. Stable fixation of the acetabular component, according to the literature, is achieved under the condition of restoration of hip rotation centre in the native acetabulum area, restoration of normal anatomical relations in the hip joint and adequate replacement of bone loss.