• BACKGROUND
    • Pelvic discontinuity is a rare but challenging condition in revision hip arthroplasty. Traditional reconstruction with anti-protrusio cages often lacks anterior support, providing no resistance against medial migration or implant protrusion, thereby potentially compromising long-term stability and implant longevity.
  • METHODS
    • This retrospective study included 13 patients with intraoperatively confirmed pelvic discontinuity who underwent revision total hip arthroplasty between 2014 and 2023. Patients were divided into two groups: Group 1 (n = 8) received anti-protrusio cage reconstruction alone, while Group 2 (n = 5) underwent additional anterior quadrilateral surface plating prior to cage implantation. Clinical and radiological outcomes were assessed with a minimum follow-up of 2 years (mean: 6.3 years), including complications, loosening, and reoperation.
  • RESULTS
    • Thirteen patients (mean age: 73.3 years) with intraoperatively confirmed pelvic discontinuity were included.Complication and reoperation rates were significantly higher in Group 1 (75%) compared to Group 2 (20%) (p < 0.001). Kaplan-Meier analysis demonstrated superior complication-free survival in Group 2 (80% at 11 years) versus Group 1 (37.5% at 11 years). Periprosthetic fracture rates did not differ significantly (p = 0.21).
  • CONCLUSION
    • Preliminary results suggest that the addition of quadrilateral surface plating may enhance construct stability and reduce complications. Further studies with larger cohorts and biomechanical validation are warranted.