Preliminary results of a 3D-printed acetabular component in the management of extensive defects

2017 ◽  
Vol 28 (3) ◽  
pp. 266-271 ◽  
Author(s):  
Mustafa Citak ◽  
Lilly Kochsiek ◽  
Thorsten Gehrke ◽  
Carl Haasper ◽  
Eduardo M Suero ◽  
...  
Keyword(s):  
Bone Loss ◽  
Acetabular Component ◽  
Complication Rate ◽  
Primary Outcome Measure ◽  
Patient Specific ◽  
Component Technique ◽  
Revision Tha ◽  
3D Printed ◽  
Acetabular Defects ◽  
Acetabular Components

Introduction: The treatment of extensive bone loss and massive acetabular defects can be compounded by several challenges and pitfalls. The survivorship following acetabular revision with extensive bone loss is still unsatisfactory. The goal of the present study was to analyse the outcomes of 3D-printed patient-specific acetabular components in the management of extensive acetabular defects and combined pelvic discontinuity (PD). Methods: 9 patients underwent revision THA using 3D-printed custom acetabular components to reconstruct extensive acetabular defects. The Paprosky classifications were determined in all patients. The primary outcome measure was the implant-associated failure rate. Results: 1 out of 9 patients suffered an implant-associated complication (11%). The overall implant-associated survival rate was 89%. The overall complication rate was 56%. Conclusions: The patient-specific acetabular component technique shows promise for the treatment of patients with severe acetabular defects in revision THA. Further research aimed at reducing costs and improving the complication rate are warranted.

Effectiveness of Trabecular Metal™ Acetabular Augment in Revision THR of Pelvis With Severe Acetabular Defect: A Finite Element Study

2007 ◽  
Author(s):  
Mehul A. Dharia ◽  
Danny L. Levine ◽  
Roy D. Crowninshield ◽  
Eik Siggelkow ◽  
Dale A. Degroff ◽  
...  
Keyword(s):  
Finite Element ◽  
Bone Loss ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Acetabular Defect ◽  
Trabecular Metal ◽  
Reconstructive Technique ◽  
Acetabular Defects ◽  
Acetabular Components ◽  
Element Study

Osteolysis of the pelvis after total hip replacement (THR) can result in several types of bony defects within or around the acetabulum [1]. These defects are classified into various categories based on the extent and location of the host bone loss [2, 3]. A severe acetabular defect with at least 30% of bone loss and progressive amounts of superior rim deficiencies can be classified as a Paprosky type IIIA cavitary defect [4] (Figure 1-I). A significant amount of superior migration of the cup can be expected as the deficient acetabulum with nonsupportive superior dome will be unable to support an acetabular component at the anatomic hip center without using structural allograft, custom implants or reconstruction cage [4, 5]. A new reconstructive technique (Figure 1-II) uses modular Trabecular Metal™ (TM) augments (Figure 1-III) to fill the acetabular defects at the time of revision THR so that regular hemispheric uncemented acetabular components can be used to allow for the potential of biologic fixation.

scholarly journals Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects

2021 ◽  
Vol 11 (4) ◽  
pp. 283
Author(s):  
Sebastian Philipp von Hertzberg-Boelch ◽  
Mike Wagenbrenner ◽  
Jörg Arnholdt ◽  
Stephan Frenzel ◽  
Boris Michael Holzapfel ◽  
...  
Keyword(s):  
Hip Joint ◽  
Successful Outcome ◽  
Patient Specific ◽  
Center Of Rotation ◽  
Type Iii ◽  
Joint Reconstruction ◽  
Acetabular Bone Loss ◽  
Custom Made ◽  
Revision Tha ◽  
Acetabular Components

Purpose: Patient-specific, flanged acetabular components are used for the treatment of Paprosky type III defects during revision total hip arthroplasty (THA). This monocentric retrospective cohort study analyzes the outcome of patients treated with custom made monoflanged acetabular components (CMACs) with intra- and extramedullary iliac fixation. Methods: 14 patients were included who underwent revision THA with CMACs for the treatment of Paprosky type III defects. Mechanism of THA failure was infection in 4 and aseptic loosening in 10 patients. Seven patients underwent no previous revision, the other seven patients underwent three or more previous revisions. Results: At a mean follow-up of 35.4 months (14–94), the revision rate of the implant was 28.3%. Additionally, one perioperative dislocation and one superficial wound infection occurred. At one year postoperatively, we found a significant improvement of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score (p = 0.015). Postoperative radiographic analysis revealed good hip joint reconstruction with a mean leg length discrepancy of 3 mm (−8–20), a mean lateralization of the horizontal hip center of rotation of 8 mm (−8–35), and a mean proximalization of the vertical hip center of rotation of 6 mm (13–26). Radiolucency lines were present in 30%. Conclusion: CMACs can be considered an option for the treatment of acetabular bone loss in revision THA. Iliac intra- and extramedullary fixation allows soft tissue-adjusted hip joint reconstruction and improves hip function. However, failure rates are high, with periprosthetic infection being the main threat to successful outcome.

scholarly journals Orthopedics and 3D technology in Turkey: A preliminary report

2021 ◽  
Vol 32 (2) ◽  
pp. 279-289
Author(s):  
Cemil Ertürk ◽  
Simel Ayyıldız ◽  
Cevdet Erdöl
Keyword(s):  
Surgical Simulation ◽  
Three Dimensional ◽  
Radiographic Examination ◽  
Acetabular Bone Defect ◽  
Custom Made ◽  
Revision Tha ◽  
3D Printers ◽  
3D Printed ◽  
Acetabular Defects ◽  
Pilon Fractures

Objectives: In this study, we present the use of case specific three- dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. Materials and methods: Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). Results: More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. Conclusion: Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D printed acetabular implants can perform an important task in patients treated with revision THA surgery due to severe acetabular defects.

scholarly journals Acetabular Component Anteversion in Primary and Revision Total Hip Arthroplasty: An Observational Study

2013 ◽  
Vol 7 (1) ◽  
pp. 600-604
Author(s):  
Olav Reikerås ◽  
Ragnhild B. Gunderson
Keyword(s):  
Acetabular Component ◽  
Target Range ◽  
Ceramic Head ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Anteversion ◽  
Target Zone ◽  
Revision Tha ◽  
Free Hand Technique ◽  
Revision Operations ◽  
Acetabular Components

Purpose: In a prospective manner to evaluate the range of acetabular component anteversion actually achieved by the use of a cup positioner in cementless revision and primary THA. Methods: We operated 71 patients with cementless primary THA, and 26 patients with cementless acetabular revision surgery. We aimed to obtain cup anteversion of 10 to 30° with an impactor-positioner. In all cases we used elevated liners and a ceramic head with diameter 28. At 3 months postoperatively the component versions were measured using CT with the patient in supine position. Results: The acetabular component version in the primary hips ranged from 28° of retroversion to 42° of anteversion with a mean of 17.4 ± 14.0°, while the cup version in the revision hips ranged from 4° of retroversion to 32° of anteversion with a mean of 15.0 ± 9.6°(p=0.427). The anteversion of 40 (56%) of the primary acetabular components were within the target zone of 10 to 30°, while 19 (27%) were below the target zone and and 12 (17%) were above the target range. The anteversion of 19 (73%) of the revision acetabular components were within the target zone, while 6 (23%) were below the target zone and 1 (4%) were above the target range. The differences in distribution between the primary and revision operations were not significant (p=0.183). Conclusions: The intraoperative estimation of acetabular anteversion by free hand technique in many cases was not within the intended range of 10 to 30° in either primary or revision THA and with no differences between the two series

scholarly journals The patient-specific Triflange acetabular implant for revision total hip arthroplasty in patients with severe acetabular defects

2018 ◽  
Vol 100-B (1_Supple_A) ◽  
pp. 50-54 ◽  
Author(s):  
M. E. Berend ◽  
K. R. Berend ◽  
A. V. Lombardi ◽  
H. Cates ◽  
P. Faris
Keyword(s):  
Surgical Technique ◽  
Acetabular Component ◽  
Ct Scanning ◽  
Harris Hip Score ◽  
Patient Specific ◽  
Complication Rates ◽  
Operative Planning ◽  
The Mean ◽  
Acetabular Defects ◽  
Acetabular Implant

Aims Few reconstructive techniques are available for patients requiring complex acetabular revisions such as those involving Paprosky type 2C, 3A and 3B deficiencies and pelvic discontinuity. Our aim was to describe the development of the patient specific Triflange acetabular component for use in these patients, the surgical technique and mid-term results. We include a description of the pre-operative CT scanning, the construction of a model, operative planning, and surgical technique. All implants were coated with porous plasma spray and hydroxyapatite if desired. Patients and Methods A multicentre, retrospective review of 95 complex acetabular reconstructions in 94 patients was performed. A total of 61 (64.2%) were female. The mean age of the patients was 66 (38 to 85). The mean body mass index was 29 kg/m2 (18 to 51). Outcome was reported using the Harris Hip Score (HHS), complications, failures and survival. Results The mean follow-up was 3.5 years (1 to 11). The mean HHS improved from 46 (15 to 90) pre-operatively to 75 (14 to 100). A total of 21 hips (22%) had at least one complication with some having more than one; including dislocation (6%), infection (6%), and femoral complications (2%). The implant was subsequently removed in five hips (5%), only one for suspected aseptic loosening. Conclusion The Triflange patient specific acetabular component provides predictable fixation with complication rates which are similar to those of other techniques. Cite this article: Bone Joint J 2018;100-B(1 Supple A):50–4.

Comparative Survival Analysis of Porous Tantalum and Porous Titanium Acetabular Components in Total Hip Arthroplasty

2017 ◽  
Vol 27 (5) ◽  
pp. 505-508 ◽  
Author(s):  
Emil S. Vutescu ◽  
Peter Hsiue ◽  
Wayne Paprosky ◽  
Sumon Nandi
Keyword(s):  
Survival Analysis ◽  
Acetabular Component ◽  
Porous Metal ◽  
Porous Titanium ◽  
Acetabular Defect ◽  
Porous Tantalum ◽  
Revision Tha ◽  
Paprosky Classification ◽  
Acetabular Components

Background Porous tantalum acetabular components (PoTa) are well-studied, but less is known about widely used porous titanium (PoTi) acetabular components. We performed a comparative survival analysis between PoTi and PoTa acetabular components. Methods Primary or revision THA performed using PoTi (n = 2,976) or PoTa (n = 184) acetabular components with minimum 2-year follow-up (PoTi n = 1,539; PoTa n = 157) were analysed. Univariate and multivariate logistic regression were performed to test the effect of porous metal acetabular component type on revision surgery for aseptic cup loosening. Multivariate model was adjusted for acetabular defect severity according to the Paprosky Classification. Results Only PoTi components used in revision THA failed. Survival of the PoTi acetabular component was 98.6% when used in revision THA at mean 48.3-month follow-up. After adjusting for severity of acetabular defect, there was no difference in survival between PoTi and PoTa acetabular components when used in primary or revision THA. Conclusions After adjusting for acetabular defect severity, both PoTa and PoTi acetabular components had excellent survival at mean 44.4-month (range 4.3-91.5 months) follow-up when used in primary and revision THA.

The 3D-printed patient-specific acetabular component in the management of extensive acetabular defect with combined bilateral pelvic discontuinity

2016 ◽  
Vol 27 (4) ◽  
pp. 272-276
Author(s):  
Mustafa Citak ◽  
Lilly Kochsiek ◽  
Thorsten Gehrke ◽  
Carl Haasper ◽  
Hans Mau
Keyword(s):  
Acetabular Component ◽  
Patient Specific ◽  
Acetabular Defect ◽  
3D Printed

scholarly journals Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1021
Author(s):  
Bernhard Dorweiler ◽  
Pia Elisabeth Baqué ◽  
Rayan Chaban ◽  
Ahmed Ghazy ◽  
Oroa Salem
Keyword(s):  
Wall Thickness ◽  
Large Scale ◽  
Fused Deposition Modeling ◽  
Vascular Anatomy ◽  
3D Models ◽  
Patient Specific ◽  
Stl File ◽  
Fused Deposition ◽  
3D Printed ◽  
The Mean

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.

scholarly journals 3D Printed Acetabular Components for Complex Revision Arthroplasty

2021 ◽  
Author(s):  
Angela Yao ◽  
Daniel Mark George ◽  
Vijai Ranawat ◽  
Chris John Wilson
Keyword(s):  
Revision Arthroplasty ◽  
3D Printed ◽  
Acetabular Components
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