PMC3367474_01
Pelvis AP identifying the migration of the reinforcement
hook into the pelvis.
TOORTHJ-6-215_F1.jpg
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F1
There was no evidence of stem loosening or migration noted (Figs. 1, 2).
Lateral view preoperative.
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F2
There was no evidence of stem loosening or migration noted (Figs. 1, 2).
Conventional CT scan preoperatively without contrast
agent.
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F3
Based on these findings and particularly the position of the anchoring hook and close proximity to intrapelvic structures, a CT scan was performed (Fig. 3).
(a-d) CT with contrast agent which clearly identifies the anatomic relation between the hook and the urether within the contrast
flow.
TOORTHJ-6-215_F4.jpg
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F4
No other relevant soft tissue encroachment was noted and an appropriate pre-operative plan was performed accordingly (Figs. 4, 5).
A further 3-D reconstruction and scrolling throughout all
slices allows the surgeon to clearly rule out a complete bracing of
the hook around the urether.
TOORTHJ-6-215_F5.jpg
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F5
No other relevant soft tissue encroachment was noted and an appropriate pre-operative plan was performed accordingly (Figs. 4, 5).
Pelvis AP final result with a complete reinforcement ring
and combined allograft impaction grafting to stabilise the all-polyethylene
cup.
TOORTHJ-6-215_F6.jpg
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F6
Leg lengths and soft tissue tensioning was restored using an additional long neck and off set variation (Fig. 6).