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. 2024 Jul;16(7):1642-1647.
doi: 10.1111/os.14097. Epub 2024 Jun 4.

3D-printed Personalized Porous Acetabular Component to Reconstruct Extensive Acetabular Bone Defects in Primary Hip Arthroplasty

Zhuangzhuang Li  1   2 , Yi Luo  1   2 , Minxun Lu  1   2 , Yitian Wang  1   2 , Taojun Gong  1   2 , Xin Hu  1   2 , Xuanhong He  1   2 , Yong Zhou  1   2 , Li Min  1   2 , Chongqi Tu  1   2
Affiliations

3D-printed Personalized Porous Acetabular Component to Reconstruct Extensive Acetabular Bone Defects in Primary Hip Arthroplasty

Zhuangzhuang Li et al. Orthop Surg. 2024 Jul.

Abstract

Objective: Management of extensive acetabular bone defects in total hip arthroplasty (THA) remains challenging. This study aims to investigate the feasibility and preliminary outcomes of 3D-printed personalized porous acetabular components for the reconstruction of acetabular defects in primary THA.

Methods: This retrospective study involved seven patients who received 3D-printed acetabular components in primary THA between July 2018 and March 2021. Preoperatively, acetabular bone defects were evaluated by referencing the Paprosky classification. There were two "Paprosky type IIIA" defects and five "Paprosky type IIIB" defects. The acetabular components were custom-made for each patient to reconstruct the extensive acetabular defects. The hip function was assessed according to the Harris hip score (HHS). Clinical and radiographic outcomes were assessed.

Results: The average follow-up period was 40 months, ranging from 26 to 57 months. There were no patients lost to follow-up. The HHS improved from 44 (range: 33-53) before the operation to 88 (range: 79-93) at the final follow-up. Postoperative X-rays showed that the 3D-printed personalized components were properly fitted with the acetabulum. The average center of rotation (COR) discrepancy was 2.3 mm horizontally and 2.1 mm vertically, respectively. Tomosynthesis-Shimadzu metal artifact reduction technology images showed that the implant was in close contact with the host bone. Moreover, no complications were observed during the follow-up period, including loosening, dislocation, or component protrusion.

Conclusion: The implantation of 3D-printed personalized acetabular components showed accurate reconstruction, stable mechanical support, and favorable function at short-term follow-up. This may be a viable alternative method for reconstructing extensive acetabular defects in THA.

Keywords: 3D‐printed; Acetabular component; Acetabular defect; Total hip arthroplasty.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Preoperative X‐ray (A) and computed tomography image (B, C) of a man aged 56 years with hip joint tuberculosis; (D, E) 3D models of the pelvis visualize the Paprosky type IIIB defect.
FIGURE 2
FIGURE 2
Design of non‐flanged component (A) and flanged component (B), and simulation of reconstructing acetabular defects.
FIGURE 3
FIGURE 3
Intraoperative pictures of a woman aged 51 years with hip joint tuberculosis using 3D‐printed flanged component to reconstruct acetabular defects: scattering the vancomycin in the acetabulum after trimming; installing the 3D‐printed personalized acetabular component; and fixing the constrained acetabular pad.
FIGURE 4
FIGURE 4
A 48‐year‐old female with syphilitic arthritis. Preoperative X‐ray (A) and computed tomography image (B) of bilateral hips; (C) Photos of the custom‐made component; X‐ray (D) and T‐SMART image (E) after surgery immediately; (F) T‐SMART image 24 months after surgery shows good osseointegration.
See this image and copyright information in PMC

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