Standard Versus Custom-Made Acetabular Implants in Revision Total Hip Arthroplasty

Тихилов, Р. М.; Джавадов, А. А.; Коваленко, А. Н.; Билык, С. С.; Денисов, А. О.; Shubnyakov, I. I.

doi:10.1016/j.arth.2021.09.003

Cited by 17 publications

(5 citation statements)

References 34 publications

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“…Using standard acetabular implants to reconstruct extensive acetabular defects may result in early aseptic loosening and the need for additional surgery. Custom-made acetabular cups have demonstrated a lower risk of early aseptic loosening and re-revision surgery [31]. Long-term studies have demonstrated that 20-35% of patients with custom implants require subsequent revision surgery [28,30,32,33], which are slightly higher than the rate observed in the present study at ten years.…”

Section: Discussioncontrasting

confidence: 63%

Survival analysis of 3D printed acetabular implants in revision total hip arthroplasty associated with severe pelvic discontinuities

Álvarez Valdivielso,

Akkaya,

Mau

et al. 2024

THC

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BACKGROUND: Surgeons still face difficulties when performing aseptic acetabular revision on patients with extensive defects. Advances in three-dimensional printing technology (3DP) have afforded to the surgeons to create a patient-specific implant matching the morphology and topography of the defect. OBJECTIVE: The aim of the current research was to determine the survivorship in the treatment of acetabular bone defects with pelvic discontinuity (PD). METHODS: In order to reconstruct Paprosky type III defects with PD, twenty-three patients underwent revision total hip arthroplasty (THA) utilizing 3D-printed implants (Mobelife). The primary outcomes were the implant-associated failure rate correlated with survivorship. As secondary variables, complications and the effect of age, sex, comorbidities, history of infections and the presence of other lower limb arthroplasties on a new revision were analyzed. RESULTS: Patients were followed out to a mean of 67.22 ± 39.44 months (range, 0.9–127 months). Mobelife implant mean survival was 102.57 ± 9.90 months (95% CI 83.17–121.96). The cohort’s implant one-year survival rate was 87%; at ten years, it dropped to 78.3%. There were four revisions: three due to periprosthetic joint infection (PJI) and one case due to aseptic loosening. Cox regression analysis did not identify any variable as predictor of failure. CONCLUSION: The use of 3DP patient-specific acetabular components has shown encouraging results and it is a viable treatment option for addressing acetabular defects with combined PD in aseptic THA revision.

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Section: Discussioncontrasting

confidence: 63%

Survival analysis of 3D printed acetabular implants in revision total hip arthroplasty associated with severe pelvic discontinuities

Álvarez Valdivielso,

Akkaya,

Mau

et al. 2024

THC

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“…( 51 ) 2021 RCS 14 14 70 (55–83) 5/9 28 (25–31) 35 (14–94) 2010 New Tikhilov et al . ( 52 ) 2022 RC 61 61 57 (NA) 9/52 28.1 (15–44) 37 (12–59) 2013 New Total 1218 1235 65.4 29/71% 27.8 *Values in parentheses are range. Min., minimum; NA, not available; PCS, prospective case series; RC, retrospective cohort; RCS, retrospective case series.…”

Section: Resultsmentioning

confidence: 99%

Custom triflange acetabular components for large acetabular defect reconstruction in revision total hip arthroplasty: a systematic review and meta-analysis on 1218 patients

Broekhuis,

Tordoir,

Vallinga

et al. 2023

EFORT Open Reviews

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Purpose This is a systematic review and meta(regression) analysis to assess the performance of custom triflange acetabular components (CTAC) in total hip arthroplasty (THA) revision surgery. Implant-related complications, failure rate, functional outcomes and implant and surgical technique-related predictors for outcome were assessed. Methods This systematic review was performed according to PRISMA guidelines and registered with PROSPERO (2020 CRD42020209700). PubMed, Embase, Web of Science, COCHRANE Library and Emcare were searched. Studies on Paprosky type 3A and 3B or AAOS type 3 and 4 acetabular defects with a minimum follow-up of 12 months and cohorts > 10 patients were included. Results Thirty-three studies were eligible for inclusion (n = 1235 hips, 1218 patients). The methodological quality of the studies was moderate (AQUILA: 7.4/11 points). Considerable heterogeneity was observed in terms of complications, re-operations and implant failure reporting. The total incidence of implant-related complications was 24%. The incidence of re-operation for any reason was 15%, and the implant failure rate was 12% at a mean of 46.9 months and the post-operative Harris Hip Score improved by a mean of 40 points. Several predictors for outcome were found, such as implant generation, follow-up length and study start date. Conclusions The use of CTAC in revision THA has satisfactory complication and implant failure rates. The CTAC technique improves post-operative clinical outcomes and the meta-regression analysis showed that there is a clear association between improvements in the CTAC performance and the evolvement of this technique over time.

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“…The interest and application of custom-made devices to treat massive acetabular bone loss in rTHA are rising [ 27 ]. A comparative analysis of rTHA suggests a higher incidence of aseptic loosening requiring re-revisions in standard acetabular prosthesis compared to custom-made implants further vindicating the use of those implants [ 28 ]. However, this procedure presents several risk factors for treatment failure to be considered, such as PJI, additional revision of femoral component, rheumatoid disease, and elevated preoperative CRP [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Custom-made implants for massive acetabular bone loss: accuracy with CT assessment

Romagnoli,

Zaffagnini,

Carillo

et al. 2023

J Orthop Surg Res

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Background Custom-made implants are a valid option in revision total hip arthroplasty to address massive acetabular bone loss. The aim of this study was to assess the accuracy of custom-made acetabular implants between preoperative planning and postoperative positioning using CT scans. Methods In a retrospective analysis, three patients who underwent an acetabular custom-made prosthesis were identified. The custom-made designs were planned through 3D CT analysis considering surgical points of attention. The accuracy of intended implants positioning was assessed by comparing pre- and postoperative CT analyzing the center of rotation (CoR), anteversion, inclination, screws, and implant surface in contact with the bone. Results The three cases presented satisfactory accuracy in positioning. A malpositioning in the third case was observed due to the posterization of the CoR of the implant of more than 10 mm. The other CoR vectors considered in the third patient and all vectors in the other two cases fall within 10 mm. All the cases were positioned with a difference of less than 10° of anteversion and inclination with respect to the planning. Conclusions The current case series revealed promising accuracy in the positioning of custom-made acetabular prosthesis comparing the planned implant in preoperative CT with postoperative CT.

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Standard Versus Custom-Made Acetabular Implants in Revision Total Hip Arthroplasty

Cited by 17 publications

References 34 publications

Survival analysis of 3D printed acetabular implants in revision total hip arthroplasty associated with severe pelvic discontinuities

Survival analysis of 3D printed acetabular implants in revision total hip arthroplasty associated with severe pelvic discontinuities

Custom triflange acetabular components for large acetabular defect reconstruction in revision total hip arthroplasty: a systematic review and meta-analysis on 1218 patients

Custom-made implants for massive acetabular bone loss: accuracy with CT assessment

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