Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity

Background:. Treatment of massive acetabular defects, both with and without pelvic discontinuity, is challenging. The implants utilized in the surgical procedure need to be stable and integrate with poor host bone stock. In the present study, we describe our experience addressing this challenge. Met...

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Autores principales:	Vitali Goriainov, BM, FRCS(Orth), Msc, PhD, Leonard J. King, MB, ChB, FRCP, FRCR, Richard O.C. Oreffo, DPhil, DSc(Oxon), FHEA, CBiol, FRSB, FIOR, Douglas G. Dunlop, MBBCh, FRCS, FRCSEd(TR&Orth), MD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/0f9923300b9043e6bce49f337cb40b3e
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spelling	oai:doaj.org-article:0f9923300b9043e6bce49f337cb40b3e2021-11-25T07:59:02ZCustom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity2472-724510.2106/JBJS.OA.21.00057https://doaj.org/article/0f9923300b9043e6bce49f337cb40b3e2021-12-01T00:00:00Zhttp://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.21.00057https://doaj.org/toc/2472-7245Background:. Treatment of massive acetabular defects, both with and without pelvic discontinuity, is challenging. The implants utilized in the surgical procedure need to be stable and integrate with poor host bone stock. In the present study, we describe our experience addressing this challenge. Methods:. We identified all patients who underwent surgical implantation of a custom 3D-printed triflange prosthesis with dual-mobility bearings for the treatment of Paprosky 3B acetabular defects between 2014 and 2020. Operative, functional, and radiographic outcomes were assessed. Results:. A total of 19 patients were identified, including 11 women. The mean age was 77 years (range, 53 to 91 years), and 8 patients (42%) had proven or likely pelvic discontinuity. The mean follow-up was 53 months (range, 17 to 88 months; mode, 57 months). The cumulative implant survivorship was 100%. Two patients suffered notable sciatic nerve palsy, with 1 case being recurrent. There were no dislocations or fractures. The mean Oxford Hip Score improved significantly, from a mean of 8.6 (range, 0 to 22) preoperatively to 35 (range, 10 to 48) postoperatively (p < 0.0001). Radiographically, there was excellent correlation between implant position and the preoperative plan (p > 0.05). There were no cases of implant loosening or migration, which suggests that stabilization was achieved even among cases with pelvic discontinuity. Conclusions:. These early results suggest that the use of a custom 3D-printed triflange implant has potential advantages over traditional constructs in the treatment of massive acetabular defects, with and without pelvic discontinuity. Excellent implant survivorship and functional improvement were demonstrated in this challenging patient cohort. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.Vitali Goriainov, BM, FRCS(Orth), Msc, PhDLeonard J. King, MB, ChB, FRCP, FRCRRichard O.C. Oreffo, DPhil, DSc(Oxon), FHEA, CBiol, FRSB, FIORDouglas G. Dunlop, MBBCh, FRCS, FRCSEd(TR&Orth), MDWolters KluwerarticleOrthopedic surgeryRD701-811ENJBJS Open Access, Vol 6, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Vitali Goriainov, BM, FRCS(Orth), Msc, PhD Leonard J. King, MB, ChB, FRCP, FRCR Richard O.C. Oreffo, DPhil, DSc(Oxon), FHEA, CBiol, FRSB, FIOR Douglas G. Dunlop, MBBCh, FRCS, FRCSEd(TR&Orth), MD Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity
description	Background:. Treatment of massive acetabular defects, both with and without pelvic discontinuity, is challenging. The implants utilized in the surgical procedure need to be stable and integrate with poor host bone stock. In the present study, we describe our experience addressing this challenge. Methods:. We identified all patients who underwent surgical implantation of a custom 3D-printed triflange prosthesis with dual-mobility bearings for the treatment of Paprosky 3B acetabular defects between 2014 and 2020. Operative, functional, and radiographic outcomes were assessed. Results:. A total of 19 patients were identified, including 11 women. The mean age was 77 years (range, 53 to 91 years), and 8 patients (42%) had proven or likely pelvic discontinuity. The mean follow-up was 53 months (range, 17 to 88 months; mode, 57 months). The cumulative implant survivorship was 100%. Two patients suffered notable sciatic nerve palsy, with 1 case being recurrent. There were no dislocations or fractures. The mean Oxford Hip Score improved significantly, from a mean of 8.6 (range, 0 to 22) preoperatively to 35 (range, 10 to 48) postoperatively (p < 0.0001). Radiographically, there was excellent correlation between implant position and the preoperative plan (p > 0.05). There were no cases of implant loosening or migration, which suggests that stabilization was achieved even among cases with pelvic discontinuity. Conclusions:. These early results suggest that the use of a custom 3D-printed triflange implant has potential advantages over traditional constructs in the treatment of massive acetabular defects, with and without pelvic discontinuity. Excellent implant survivorship and functional improvement were demonstrated in this challenging patient cohort. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
format	article
author	Vitali Goriainov, BM, FRCS(Orth), Msc, PhD Leonard J. King, MB, ChB, FRCP, FRCR Richard O.C. Oreffo, DPhil, DSc(Oxon), FHEA, CBiol, FRSB, FIOR Douglas G. Dunlop, MBBCh, FRCS, FRCSEd(TR&Orth), MD
author_facet	Vitali Goriainov, BM, FRCS(Orth), Msc, PhD Leonard J. King, MB, ChB, FRCP, FRCR Richard O.C. Oreffo, DPhil, DSc(Oxon), FHEA, CBiol, FRSB, FIOR Douglas G. Dunlop, MBBCh, FRCS, FRCSEd(TR&Orth), MD
author_sort	Vitali Goriainov, BM, FRCS(Orth), Msc, PhD
title	Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity
title_short	Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity
title_full	Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity
title_fullStr	Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity
title_full_unstemmed	Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity
title_sort	custom 3d-printed triflange implants for treatment of severe acetabular defects, with and without pelvic discontinuity
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/0f9923300b9043e6bce49f337cb40b3e
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Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity

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