Using Custom Triflange Implant in Revision Hip Arthroplasty in Patient With Pelvic Discontinuity (Case Report)

Abstract

Revision hip arthroplasty rate is growing, and pelvic discontinuity rate ranges from 1% to 5% of acetabular component revision reasons. According to AAOS acetabular defects classification, pelvic discontinuity is fourth type defect in which cranial part of hip bone is separated from caudal part at acetabular level. Usually it occurs from bone loss secondary to osteolysis, infection, fracture or aseptic loosening. There are a lot of techniques for pelvis discontinuity treatment. Published results of bulk allografts and antiprotrusion cages have generally been poor. More preferable methods with acceptable rate of good results are cup-cage systems and custom triflange acetabular components(CTAC). CTACs are designed based on preoperative CT scans to build a custom titanium 3D-printed implant to address the patient's specific bone defect and provide secure fixation in the ilium, pubis, and ischium. We faced pelvic discontinuity, in which extensive iliac bone loss was added to caudal hip bone part medial displacement and pelvic ring deformity, in patient with multiple hip surgeries. Preoperative investigation called into question the possibility of using off-the-shelf hip implants, which could restore the biomechanics of the hip and provide reliable primary fixation at the same time. We present case report of the patient with pelvic discontinuity and massive bone loss treatment using a custom triflange component.

Additive manufacturing technique-designed metallic porous implants for clinical application in orthopedics

“…In these cases, 3DP customized triflange acetabular component (CTAC) was implanted into bone defect precisely, and all implants showed reliable fixation in the ischium, pubis and ilium. 173 Other researchers also implanted 3DP CTAC into pelvic discontinuity, and found that there were improved HHS score without complications. 174 This technique is a reliable and promising option in these cases.…”

What we have achieved in the design of 3D printed metal implants for application in orthopedics? Personal experience and review

“…In such cases, it is hard to provide reliable fixation of the acetabular component because of limited contact surface with host bone and movement of bone fragments. In an aseptic loosening of the acetabular component and pelvic discontinuity case, 3DP customized triflange acetabular component (CTAC) fit the bone defect precisely and provided reliable fixation in the ischium, pubis and ilium (Tikhilov et al , 2016). Kavalersky et al also used 3DP CTAC in pelvic discontinuity, and no complications were found and HHS scores were significant improved (Kavalersky et al , 2016).…”

Minimum One-Year Outcomes after Revision Hip Arthroplasty with Custome-Made Implants: Function, Quality of Life and Patients Satisfaction

“…Ивк для реконструкции значительных дефектов вертлужной области на сегодняшний день не являются революционным методом лечения [15][16][17][18][19][20]. однако в нашей стране первая подобная операция была выполнена менее трех лет назад [22]. Целый ряд вопросов требует дальнейшего освещения как в отечественной, так и в зарубежной литературе.…”