Der Orthopäde
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This report documents our limited experience with total hip replacement requiring large bone-graft reconstruction of the acetabulum with internal fixation. Four of the 14 patients were elderly and had a fresh fracture of the acetabulum; 6 had severe loosening of the acetabular companent with non-union, necessitating plate fixation along the pelvic rim in 5 patients. Four patients had large defects after tumor resection. ⋯ Our results are promising and we plan to increase the use of pelvic plates in these extremely unstable cases. Following stabilization of the pelvic ring, a metallic reinforcement ring increases stability. These operations were performed via an anterior ilioinguinal approach.
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Thirteen out of 17 patients with a hip prosthesis according to the Girdlestone procedure were studied at a follow-up time of 26 months to 10 years. Seven patients were found to be satisfied with the total prosthesis, while the others complained about pain, walking disability and an insufficient range of motion. The implantation of a prosthesis using the Girdlestone procedure is technically difficult and should be restricted, as the results are superior to the Girdlestone hip in only a carefully selected group of patients with good abductor muscles and unsatisfactory results after the Girdlestone operation.