preoperative planning

Aetiology

Trauma

RA

Rickets / osteomalacia

Issues

Horizontal joint line important

- < 10° tilt acceptable

> 10^o joint line tilt / due to femoral valgus

- continues to overload lateral compartment

Principles of Acetabular reconstruction

Restore centre of rotation
Restore acetabular integrity
Component containment
Secure fixation

Preoperatively planning

Know components in situ (esp if leaving femur)
Quantify and grade bone defects
Beware intrapelvic cement / cup (angiogram)

Pre-operative Planning

CT / quantify bone loss
X match 4 units
Cell saver
Anaesthetic review
Bone graft (cortical, cancellous)
Component removal gear

- extraction gear for femur / liners

- cement removers for cemented femur

- curved osteotomes for cemented cup

- X-plant for uncemented cup
Revision long stem femoral implants
Revision acetabular implants including cages