Purposes are to determine1) what frequency and what degree is of custom acetabular implants malposition in comparison with planned position, 2) what the reason of malposition is and 3) what the malposition consequences we can wait for.Patients and methods. The observation group included 20 patients (18 women and 2 men) with severe ac-etabular defects. Mean age of patients made up 53 (22-72) years. Position of the implants was compared with the parameters of preoperative planning using 5 postoperative CT indices (inclination, anteversion of semi-spherical part of the implant, spatial location of the rotation center in three axes). More than 10° deviation for inclination or anteversion and 5° dislocation of the rotation center in any axis was considered as a malposition of the component.Results. Only 5 of 20 constructions matched conditionally permissible limits by all the parameters. Most often excessive dislocation of the rotation center in lateral direction (10 cases) and excessive anteversion (9 cases) were observed. During 6 weeks follow up no complications related to the acetabular component position were recorded.Conclusion. It was shown that at revision arthroplasty with custom-made implants the probability of implant malposition as compared to the preoperative plan. The main reason could be the complexity of intraoperative orientation under conditions of abnormal hip anatomy. Malposition of the implants beyond the stated values did not result in complications within the early postoperative period. The longer follow up is required for the assessment of the long-term results.

Background.Total hip arthroplasty (THA) is reliable and successful intervention in terms of relieving pain andimproving joint function. Between 7% and 16% of patients are dissatisfied after THA. To assess predictors and postoperative determinants of satisfaction 3 and 12 months after THA. Material and Methods.During our research from 2015 to 2017 prospectively 1015 patients were interviewedusing patient related outcome measures (a questionnaire of functional outcome (Oxford Hip Score, Harris Hip Score), health-related quality of life (EQ-5D)) preoperatively, 3 and 12 months postoperatively. Satisfaction was assessed using Visual Analogue Scale (VAS). Also Univariate and multivariate analyses were performed. Results.A female gender, absence of interventions on the operated joint in history were preoperative predictorsof satisfaction. The main postoperative determinant of satisfaction was the fulfillment of patient’s expectations, improve physical function, quality of life, relief of pain. Conclusion.To improve patient satisfaction after THA, patients’ expectations and their fulfillment need to becarefully addressed. Patients with a history of interventions on the operated joint with low physical function or quality of life, high level of pain should be identified and specifically informed on expected surgical outcome

Introduction. The matter of the replacement of acetabular defects is becoming increasingly relevant today. In their clinic the authors used custom-made implants with trabecular coating for replacement of defects in the acetabulum where and when it was necessary to ensure extended fixation of the component. Purpose — to evaluate short-term clinical and functional outcomes, osteointegration of porous coated custom-made implants, the overall survival of structural components and to identify the causes of failures and complications. Materials and Methods. During the study the authors interviewed and evaluated radiographs of 48 patients operated from October 2015 to June 2018. The patients were interviewed before and after the surgery using the Oxford hip joint scale, quality of life EQ-5D and visual analogue pain scale. Radiographs were evaluated for a period of at least 12 months for the signs of osteointegration. Results. The average OHS scores increased from 14.9 (±7) to 37.6 (±7) (p<0.01). Quality of life according to the EQ-5D index increased from 0.2 (±0.2) to 0.7 (±0.2) (p<0.01). The average value by general health scales: before operations — 49 (±17) and 73 (±18) scores after surgeries (p<0.01). The average VAS pain score decreased from 73 (±10) to 19 (±19) points (p<0.01). Osteointegration was observed in 98 percent of cases. Migration of the implant with fracture of a flange was observed in one case. Conclusions. In the short-term follow up the use of custom-made implants significantly improves hip joint function and the patients’ life quality. Custom-made implants enable primary reliable fixation in case of complex acetabular defects. High rate of osteointegration is observed for custom-made implants with porous coating within at least 12 months. Longer follow-up is needed to evaluate long-term results.

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