Custom Triflange Acetabular Components in Revision Hip Replacement (Experience Review)

Корыткин, А. А.; Zakharova, D. V.; Новикова, Я С; Gorbatov, Roman O.; Ковалдов, К А; Мудни, Ю М Эль

doi:10.21823/2311-2905-2017-23-4-101-111

Cited by 17 publications

(7 citation statements)

References 19 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Significant acetabular defects, especially together with pelvis discontinuity, are a serious problem and make each revision hip replacement rather unique [17]. The fixing of such acetabular components is an additional challenge.…”

Section: Case Study 4: Flanged Acetabular Cup With Augmentmentioning

confidence: 99%

See 1 more Smart Citation

Design and 3D-printing of titanium bone implants: brief review of approach and clinical cases

et al. 2018

View full text Add to dashboard Cite

Additive manufacturing (AM) is an alternative metal fabrication technology. The outstanding advantage of AM (3Dprinting, direct manufacturing), is the ability to form shapes that cannot be formed with any other traditional technology. 3D-printing began as a new method of prototyping in plastics. Nowadays, AM in metals allows to realize not only netshape geometry, but also high fatigue strength and corrosion resistant parts. This success of AM in metals enables new applications of the technology in important fields, such as production of medical implants. The 3D-printing of medical implants is an extremely rapidly developing application. The success of this development lies in the fact that patientspecific implants can promote patient recovery, as often it is the only alternative to amputation. The production of AM implants provides a relatively fast and effective solution for complex surgical cases. However, there are still numerous challenging open issues in medical 3D-printing. The goal of the current research review is to explain the whole technological and design chain of bio-medical bone implant production from the computed tomography that is performed by the surgeon, to conversion to a computer aided drawing file, to production of implants, including the necessary post-processing procedures and certification. The current work presents examples that were produced by joint work of Polygon Medical Engineering, Russia and by TechMed, the AM Center of Israel Institute of Metals. Polygon provided 3D-planning and 3Dmodelling specifically for the implants production. TechMed were in charge of the optimization of models and they manufactured the implants by Electron-Beam Melting (EBM Ò), using an Arcam EBM Ò A2X machine. Keywords Additive manufacturing Á Bio-medical implants Á Electron beam melting Á 3D-printing Á Ti-6Al-4V Á CAD design Á Computed tomography

show abstract

Section: Case Study 4: Flanged Acetabular Cup With Augmentmentioning

confidence: 99%

“…The fixing of such acetabular components is an additional challenge. However, there are already multiple surgeries showing positive results using 3D-printed acetabular flanged cup implants [17][18][19]. The surgery primary endoprosthetics, was conducted in 2004.…”

Section: Case Study 4: Flanged Acetabular Cup With Augmentmentioning

confidence: 99%

Design and 3D-printing of titanium bone implants: brief review of approach and clinical cases

et al. 2018

View full text Add to dashboard Cite

show abstract

“…классификация Paprosky была предложена около 25 лет назад и все это время служила алгоритмом для принятия хирургических решений, основанных на анализе анатомических изменений по обзорной рентгенограмме таза. за это время в нашу практику прочно вошла компьютерная томография с возможностью металлоподавления и трехмерной реконструкцией изображения, что, с одной стороны, существенно расширило возможности визуализации вертлужной впадины, а с другой, -создало предпосылки для прототипирования дефектов и виртуального планирования операций, как для стандартных конструкций, так и, где это невозможно, индивидуальных имплантатов [49,50]. поэтому встает резонный вопрос: а нужна ли нам сегодня классификация Рaprosky (или любая другая) для описания дефектов вертлужной впадины?…”

Section: рис 5 (D Eunclassified

Classifications of Acetabular Defects: Do They Provide an Objective Evidence for Complexity of Revision Hip Joint Arthroplasty? (Critical Literature Review and Own Cases)

Тихилов

Shubnyakov

Шубняков³

et al. 2019

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

The present paper bears discussion in nature and doesn’t claim for any scientific evidence.The purpose is to identify which classification of acetabular defects currently is the most employed in revision hip joint arthroplasty, and how precise this classification reflects the true defect severity and gives the objective grounds for selection of revision implants.Materials and methods. The authors conducted literature analysis in PubMed and eLIBRARY for the last five years. 170 publications in English, German and Spanish languages as well as 15 works in Russian language dedicated to classification of acetabular defects were selected.Results. W.Paprosky classification was found to be the most applicable, namely, in 65,9% of foreign publications and in 100% of Russian papers. AAOS classification was used in 22.9% of cases, Gross and Saleh — in 4.1%, Gustilo and Pasternak — in 1.2%. 5.9% publications reported use of two classifications. The reasons for Paprosky classification popularity is the possibility to evaluate defect basing on standard pelvis x-rays in preoperative stage as well as in retrospective research. At the same time, according to literature, the confidence of Paprosky classification (accuracy of correspondence to intraoperative findings) varies from 16 to 66% for different areas of acetabulum, and during reliability assessment (consistency between different specialists) kappa coefficient varies from 0.14 to 0.75 depending on experience of the specialist and specifics of the defect. One of the possible reason for discrepancies in assessment of defect grade are the iatrogenic and posttraumatic changes of the acetabulum. Nevertheless, Paprosky classification is evolving and, considering additional parameters, like type of defect (contained or non-contained) and pelvic ring continuity, it allows to create a full-fledge algorithm for selection of revision implants and defect replacement which is adequate to the up-to-date surgical needs. At the same time onrush of digital technologies of 3D-visualization considerably expands our possibilities for preoperative defects assessment and offers promising potential for development of new classifications, whose benefits are yet to be evaluated.

show abstract

“…[25]. Но благодаря государственной поддержке широкое распространение и повышение доступности аддитивного производства в России привело к тому, что в настоящий момент число имплантаций индивидуальных конструкций исчисляется десятками в крупных центрах эндопротезирования [26,27]. Однако, учитывая повышенную сложность операций и отсутствие четко сформированной философии применения персонифицированных имплантатов при ревизии, многие аспекты применения индивидуальных конструкций требуют изучения и тщательного наблюдения.…”

Section: результатыunclassified

Mid-term Outcomes of Using Custom-Made Implants for Revision Hip Arthroplasty

Коваленко

Джавадов

Shubnyakov

et al. 2019

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

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.

show abstract

Custom Triflange Acetabular Components in Revision Hip Replacement (Experience Review)

Cited by 17 publications

References 19 publications

Design and 3D-printing of titanium bone implants: brief review of approach and clinical cases

Design and 3D-printing of titanium bone implants: brief review of approach and clinical cases

Classifications of Acetabular Defects: Do They Provide an Objective Evidence for Complexity of Revision Hip Joint Arthroplasty? (Critical Literature Review and Own Cases)

Mid-term Outcomes of Using Custom-Made Implants for Revision Hip Arthroplasty

Contact Info

Product

Resources

About