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Clinical Trial
. 2020 Dec 10;21(1):835.
doi: 10.1186/s12891-020-03851-9.

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Michael S Gruber  1 , Michael Jesenko  2 , Julia Burghuber  1 , Josef Hochreiter  3 , Peter Ritschl  2 , Reinhold Ortmaier  4   5
Affiliations
Clinical Trial

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Michael S Gruber et al. BMC Musculoskelet Disord. .

Abstract

Background: Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects.

Methods: Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics.

Results: The mean follow-up time of the nine patients was 12.2 months (range: 10-18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset.

Conclusions: The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined.

Level of evidence: Therapeutic Level IV.

Keywords: 3D-printed prosthesis; CTAC; Custom-made acetabular component; Revision surgery; Severe acetabular bone loss; Total hip arthroplasty.

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Conflict of interest statement

To the authors’ knowledge, there are no potential competing interests.

Figures

Fig. 1
Fig. 1
Quantification of acetabular bone loss and assessment of bone quality. Source: planning report provided by Materialise NV, Leuven, Belgium. Permission from the copyright holder to publish the figure has been obtained
Fig. 2
Fig. 2
Preparation and reconstruction. From left to right: planned bone removal, bone after removal, proposed implant design (porous augment and plate are built as one part). Source: planning report provided by Materialise NV, Leuven, Belgium. Permission from the copyright holder to publish the figure has been obtained
Fig. 3
Fig. 3
Pre- vs. postoperative Harris Hip Score
Fig. 4
Fig. 4
Pre- vs. postoperative Oxford Hip Score
Fig. 5
Fig. 5
I) Measurement of offsets in a hip with aseptic loosening (a: femoral offset; b: medial offset; c: ilioischial offset; d: center of rotation) II) shows the same hip after revision with CTAC
See this image and copyright information in PMC

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