scholarly journals Comparison of 3D Printing Rapid Prototyping Technology with Traditional Radiographs in Evaluating Acetabular Defects in Revision Hip Arthroplasty: A Prospective and Consecutive Study

2021 ◽  
Author(s):  
Jing‐wei Zhang ◽  
Xiao‐liang Liu ◽  
Yi‐ming Zeng ◽  
Zan‐jing Zhai ◽  
Yuan‐qing Mao ◽  
...  
Keyword(s):  
3D Printing ◽  
Rapid Prototyping ◽  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Acetabular Defects

scholarly journals Three-dimensional models in planning of revision hip arthroplasty with complex acetabular defects

2018 ◽  
Vol 52 (6) ◽  
pp. 625 ◽  
Author(s):  
YaroslavA Rukin ◽  
GennadiyM Kavalerskiy ◽  
ValeriyY Murylev ◽  
PavelM Elizarov ◽  
AlexeyV Lychagin ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Revision Hip Arthroplasty ◽  
Dimensional Models ◽  
Three Dimensional Models ◽  
Acetabular Defects

scholarly journals 3D Printing Aids Acetabular Reconstruction in Complex Revision Hip Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Andrew J. Hughes ◽  
Cathal DeBuitleir ◽  
Philip Soden ◽  
Brian O’Donnchadha ◽  
Anthony Tansey ◽  
...  
Keyword(s):  
3D Printing ◽  
Hip Arthroplasty ◽  
Surgical Simulation ◽  
Selective Laser Sintering ◽  
Three Dimensional ◽  
3D Models ◽  
Tactile Feedback ◽  
Revision Hip Arthroplasty ◽  
Acetabular Reconstruction ◽  
Acetabular Cup

Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology and manufacturing technology have made three-dimensional (3D) representation of osseous anatomy obtainable, which provide visual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip joints in two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting in right-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stage revision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images were imported into Materialise MIMICS 14.12®. The models were manufactured using selective laser sintering. Accurate templating was performed preoperatively. Acetabular cup, augment, buttress, and cage sizes were trialled using the models, before being adjusted, and resterilised, enhancing the preoperative decision-making process. Screw trajectory simulation was carried out, reducing the risk of neurovascular injury. With 3D printing technology, complex pelvic deformities were better evaluated and treated with improved precision. Life-size models allowed accurate surgical simulation, thus improving anatomical appreciation and preoperative planning. The accuracy and cost-effectiveness of the technique should prove invaluable as a tool to aid clinical practice.

scholarly journals Modular Tantalum Augments for Acetabular Defects in Revision Hip Arthroplasty

2008 ◽  
Vol 467 (1) ◽  
pp. 199-205 ◽  
Author(s):  
Alexander Siegmeth ◽  
Clive P. Duncan ◽  
Bassam A. Masri ◽  
Winston Y. Kim ◽  
Donald S. Garbuz
Keyword(s):  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Acetabular Defects

scholarly journals What Characteristics of the Acetabular Defect Influence the Choice of the Acetabular Component During Revision Hip Arthroplasty?

2020 ◽  
Vol 26 (2) ◽  
pp. 31-49
Author(s):  
R. M. Tikhilov ◽  
A. A. Dzhavadov ◽  
A. N. Kovalenko ◽  
A. O. Denisov ◽  
A. S. Demin ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Retrospective Cohort ◽  
Defect Formation ◽  
Bone Defects ◽  
Revision Hip Arthroplasty ◽  
Acetabular Defects ◽  
Type 3 ◽  
Revision Operations

The purposes of the retrospective cohort study were: 1) to determine the severity of defects in the acetabulum and the probable causes of their formation in patients who underwent revision hip arthroplasty (RHA), as well as an assessment of factors that exacerbate the severity of the defects; 2) identifying the proportion of severe defects in the overall structure of acetabular revisions and determining the effectiveness of using serial implants in comparison with individual constructions made by 3D printing; 3) the rationale for rational indications for the use of individual constructions.Materials and Methods. The structure and reasons for the formation of bone defects in the acetabulum were evaluated in 726 cases of revisions performed from 2004 to 2018. In addition, the results of revision operations in a group of patients with severe defects (type 3 according to Paprosky and pelvic discontinuity) were evaluated.Results. The most frequent cause of defect formation was iatrogenic (53.2%), and the share of severe defects was 39.5% (287 observations). A factor aggravating the severity of the defect is the lack of its limitation by the support bone. The results of RHA in patients with severe defects were assessed in 186 cases out of 287 (64.8%). In 73 (39.2%) cases, individual constructions were used, the average follow-up was 26 months. (from 12 to 50), and in 113 (60.8%) cases, serial implants were used, the average follow-up period was 62 months. (12 to 186). Individual constructions were more often implanted in patients with 3B acetabular defects (p<0.05) and its uncontained defects (p<0.001). The number of cases of aseptic loosening in the group of patients undergoing endoprosthetics using serial implants was greater than in the group of patients with individual constructions for the entire period (p<0.05) and in the early stages of observation (p<0.05).Conclusion. In case of RHA in patients with severe acetabular defects, individual implants, in comparison with serials, demonstrate better survival with an average follow-up of 26 months and due to design features, they can count on great long-term effectiveness. This study needs to be continued to increase follow-up.

Osteoplastic Substitution of Acetabular Defects at Revision Hip Arthroplasty

2013 ◽  
Vol 20 (4) ◽  
pp. 29-33
Author(s):  
N. V Zagorodniy ◽  
V. I Nuzhdin ◽  
I. A Nikolaev ◽  
S. V Kagramanov ◽  
V. S Komlev
Keyword(s):  
Bone Tissue ◽  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Treatment Result ◽  
X Rays ◽  
Acetabular Defect ◽  
Patient Volume ◽  
Calcium Orthophosphates ◽  
Paprosky Classification ◽  
Acetabular Defects

First experience in application of synthetic and natural osteoconductive biocompatible materials of calcium orthophosphates that gradually resorb and are substituted by newly formed bone tissue is presented. Those osteoplastic materials were used in 11 patients aged 45–78 years at revision hip arthroplasty due to unstable acetabular component. According to W. Paprosky classification II A type of acetabular defect was diagnosed in 2 patients, II B type — in 2, II C type — in 3, III A type — in 3 and type III B — in 1 patient. Volume of used material was determined by the size of bone defect and ranged from 10 to 50 g. At terms from 3 to 18 months satisfactory treatment result was observed in all patients. Control X-rays and computed tomograms showed that structure of remodeled bone tissue approximated to the acetabular structure and its’ density almost corresponded to pelvic bones density.

scholarly journals Acetabular reconstruction using 3D printing in revision hip arthroplasty

2015 ◽  
Vol 23 ◽  
pp. S82
Author(s):  
A. Hughes ◽  
B. O'Donnchadha ◽  
A. Tansey ◽  
C. McMahon ◽  
C. Hurson
Keyword(s):  
3D Printing ◽  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Acetabular Reconstruction

scholarly journals Treatment of Acetabular Defects with Porous Metal Augments in Revision Hip Surgery

PRILOZI ◽  
2019 ◽  
Vol 40 (2) ◽  
pp. 33-39
Author(s):  
Jasmin Ciriviri ◽  
Zoran Nestorovski ◽  
Darko Talevski ◽  
Tode Vranishkovski ◽  
Hristijan Kostov
Keyword(s):  
Hip Arthroplasty ◽  
Bone Ingrowth ◽  
Weight Bearing ◽  
Porous Metal ◽  
Lateral Approach ◽  
Revision Hip Arthroplasty ◽  
Acetabular Cup ◽  
Local Bone ◽  
Acetabular Defects

Abstract Porous metal augments have been used successfully for management of large acetabular defects during revision hip arthroplasty. This study analyzes and compares the clinical and radiographic outcomes of porous metal augments in cemented and uncemented acetabular revisions, all performed at the same institution. In the period 2015-2017, 36 patients with 37 large acetabular defects were treated with porous metal augments in cemented and uncemented acetabular revisions. Postoperatively, patients were monitored for two years on average period of 24-36 months. Acetabular augments were used when preoperative and intraoperative findings indicated the presence of large acetabular defects that can hinder the stability of the revision implants. We used lateral approach, 36 mm femoral head, and cementless or cemented acetabular cup depending on local bone quality. Postoperatively, all patients followed total hip arthroplasty precautions, with weight bearing as tolerated regimen with use of crutches during 6 weeks after surgery. The follow-up was radiological and clinical. We used HHS. At a mean follow-up of two years (range 24-36 months) one patient had reinfection and one patient had infection. None of the patients shown signs of aseptic augment or acetabular cup loosening. Porous metal augments show comparable excellent radiographic and clinical short-term outcomes, when combined with cemented or uncemented cups in revision hip arthroplasty. They allow good bone ingrowth, adequate implant contact and good stability. Complications were related to infection and not related to the augments itself.

scholarly journals Custom Triflange Acetabular Components for Revision Hip Arthroplasty in the Patients with Severe Acetabular Defects: Planning, Surgical Technique, Outcomes

2020 ◽  
Vol 26 (2) ◽  
pp. 20-30
Author(s):  
A. A. Korytkin ◽  
Ya. S. Novikova ◽  
E. A. Morozova ◽  
S. A. Gerasimov ◽  
K. A. Kovaldov ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Hip Arthroplasty ◽  
Pelvic Ring ◽  
Term Treatment ◽  
Revision Hip Arthroplasty ◽  
Short Term Treatment ◽  
Pelvic Ring Disruption ◽  
Acetabular Defects ◽  
Acetabular Components

Employment of custom triflange acetabular components (CTAC) is one of the few options for pelvic reconstruction in the patients requiring complex acetabulum revisions with Paprosky 2 C, 3 A and 3 B defects and pelvic ring disruption.The purpose of the study was to describe the features of planning, surgical technique, and short-term treatment outcomes of the patients with significant acetabular defects, in which the revision hip arthroplasty was performed using the CTAC.Materials and Methods. A single-center analysis of a series of consecutive patients was performed: 50 complex acetabulum revisions in 47 patients (16 men and 31 women). The average age of the patients was 60±12 years (from 31 to 82; Me 62 years), the average body mass index was 29.7±6.3 kg/m2 (18.4 to 46.3; Me 29.0 kg/m).Results. The mean follow-up was 22±13 months (from 3 to 3.6 years; Me 20 months). The average Harris score increased from 27±7 (from 15 to 39; Me 27) before surgery to 64±16 (from 22 to 90; Me 67) a year after (p<0.001). The level of pain according to VAS before surgery was 7±1 points (from 5 to 9; Me 7), after treatment it decreased to 2±1 points (from 0 to 7; Me 1, p<0.001). In 17 cases out of 50 (34%), there was at least one complication: dislocations — 7 (14%) cases; infection — 3 (6%); loosening — 2 (4%); complications associated with the femoral component — 4 (8%), including 3 intraoperative fractures and 1 postoperative, associated with loosening of the implant; pronounced disturbances of static and locomotor functions — 2 (4%). 12 cases out of 50 (24%) required another surgery, all of which were performed in a year. The Kaplan-Meyer survival rate for the hip implants was 0.71, for the CTAC — 0.87.Conclusion. Employment of the CTAC for revision hip arthroplasty in the patients with significant acetabulum defects and pelvic ring disruption allows reliable fixation of the endoprosthesis components. The STAC placement technique is more anatomical than use of structural allografts, several augments or sup-cage systems. It allows reconstruction of extensive bone defects, theoretically avoiding the long-term problems with allografts, modular trabecular components, antiprotrusion systems and cup-cage. Although, to prove this, the longer follow-up is needed.

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