Neurovascular Injuries in Acetabular Reconstruction Cage Surgery. An Anatomical Study

Carlos J. Lavernia, Christopher C. Cook, Ruben A. Hernandez, Rafael J. Sierra, Mark D. Rossi

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Acetabular reconstruction cages are indicated for severe combined segmental and cavitary acetabular bone defects. The purpose of this study was to evaluate the implications of screw placement and drill plunge and the potential insult to anatomical structures when implanting acetabular reconstruction cages. A segmental cavitary defect was reamed into the acetabulum and a cage was implanted in each of the 10 hemipelvises. The relative course of the superior gluteal neurovascular bundle was mapped to assess dissection intervals. When cage screws were placed at least 15 mm longer than needed, 13% and 20% of screws of the superior flange and anterior rim hit the femoral nerve, respectively, and approximately 60% of the screws placed in the posterior rim endangered the obturator nerve. A "safe zone" for screw size may be a 15- and 25-mm screw for the superior flange and posterior rim, respectively.

Original languageEnglish (US)
Pages (from-to)124-132
Number of pages9
JournalJournal of Arthroplasty
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2007

Keywords

  • acetabular defects
  • neurovascular structures
  • pelvic structures

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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    Lavernia, C. J., Cook, C. C., Hernandez, R. A., Sierra, R. J., & Rossi, M. D. (2007). Neurovascular Injuries in Acetabular Reconstruction Cage Surgery. An Anatomical Study. Journal of Arthroplasty, 22(1), 124-132. https://doi.org/10.1016/j.arth.2006.02.082