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| Pre-op | Intra-op | Post-op | Discussion | References
Intra-operative Management:
Findings/Operative Management: The abductors were very deficient but present. Once the area was exposed, the patient was noted to have a severe segmental and cavitary lesion of her acetabulum. She had only a small posterior column left. No posterior wall, no anterior column, and no medial wall confirming our type III-B defect (Paprosky). She fortunately had no evidence of infection, no acute inflammation nor any PMN's or organisms on gram stain. We were able to build a solid construct with a acetabular reinforcement cage. First we morselized two femoral head allografts. We then placed the morselized cancellous allograft into the defect. We then contoured a Protek acetabular reinforcement cage to fit her remaining acetabulum. We were able to place a total of 5 solid screws into the ilium and ischium thereby securing the cage to her pelvis. we felt the ring had excellent support to the host bone.We then trialed the polyethylene liners with the femoral trial to be sure tchoose the appropriate cemented polyetheylene acetabular liner to be placed into the cage. Care was taken to assess the cup closure, version, soft tissue tension and stability. Once ready, all components were cemented into position utilizing Tobramycin in the cement. The remnant abductors were reattached to the remaining trochanter during the closure. Implants:
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