Custom-made Implants for Massive Acetabular Bone Loss: Accuracy with CT Assessment

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2023 Sep 30

PMID 37777776

Authors

Matteo Romagnoli

Marco Zaffagnini

Eleonora Carillo

Federico Raggi

Marco Casali

Alberto Leardini

Giulio Maria Marcheggiani Muccioli

Alberto Grassi

Stefano Zaffagnini

Affiliations

Soon will be listed here.

Abstract

Background: Custom-made implants are a valid option in revision total hip arthroplasty to address massive acetabular bone loss. The aim of this study was to assess the accuracy of custom-made acetabular implants between preoperative planning and postoperative positioning using CT scans.

Methods: In a retrospective analysis, three patients who underwent an acetabular custom-made prosthesis were identified. The custom-made designs were planned through 3D CT analysis considering surgical points of attention. The accuracy of intended implants positioning was assessed by comparing pre- and postoperative CT analyzing the center of rotation (CoR), anteversion, inclination, screws, and implant surface in contact with the bone.

Results: The three cases presented satisfactory accuracy in positioning. A malpositioning in the third case was observed due to the posterization of the CoR of the implant of more than 10 mm. The other CoR vectors considered in the third patient and all vectors in the other two cases fall within 10 mm. All the cases were positioned with a difference of less than 10° of anteversion and inclination with respect to the planning.

Conclusions: The current case series revealed promising accuracy in the positioning of custom-made acetabular prosthesis comparing the planned implant in preoperative CT with postoperative CT.

Citing Articles

Custom-Made 3D-Printed Augments and Cages: An Effective Solution for Managing Severe Acetabular Bone Loss.

Annapareddy A, Bose V, Katariya A, Mulpur P, Jayakumar T, Ansari M J Orthop Case Rep. 2025; 15(1):208-214.

PMID: 39801861 PMC: 11723743. DOI: 10.13107/jocr.2025.v15.i01.5180.

[Research progress of three-dimensional printed customized prosthesis and its application in acetabular reconstruction of hip revision surgery].

Zhang H, Ma X, Li B, Li K, Liu Y, Zhou J Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024; 38(11):1414-1420.

PMID: 39542636 PMC: 11563742. DOI: 10.7507/1002-1892.202406002.

Does the interface between individual 3D acetabular implants and host bone influence the functional outcomes in patients with severe bone loss after revision surgery?.

Murylev V, Kukovenko G, Efimenko O, Muzychenkov A, Elizarov P, Rudnev A SICOT J. 2024; 10:42.

PMID: 39450974 PMC: 11504249. DOI: 10.1051/sicotj/2024040.

Assessment Accuracy of 2D vs. 3D Imaging for Custom-Made Acetabular Implants in Revision Hip Arthroplasty.

Nees T, Mueller C, Innmann M, Spranz D, Westhauser F, Renkawitz T J Pers Med. 2024; 14(8).

PMID: 39202000 PMC: 11355157. DOI: 10.3390/jpm14080808.

Optimizing Acetabular Positioning: A Comprehensive Review of Contemporary Strategies in Total Hip Arthroplasty.

Teja T, Shrivastava S, Choudhary A, Rathod V, Balusani P Cureus. 2024; 16(4):e59114.

PMID: 38803755 PMC: 11128723. DOI: 10.7759/cureus.59114.

References

Zampelis V, Flivik G . Custom-made 3D-printed cup-cage implants for complex acetabular revisions: evaluation of pre-planned versus achieved positioning and 1-year migration data in 10 patients. Acta Orthop. 2020; 92(1):23-28. PMC: 7919918. DOI: 10.1080/17453674.2020.1819729. View

Chiarlone F, Zanirato A, Cavagnaro L, Alessio-Mazzola M, Felli L, Burastero G . Acetabular custom-made implants for severe acetabular bone defect in revision total hip arthroplasty: a systematic review of the literature. Arch Orthop Trauma Surg. 2020; 140(3):415-424. DOI: 10.1007/s00402-020-03334-5. View

Ng N, Gaston P, Simpson P, Macpherson G, Patton J, Clement N . Robotic arm-assisted versus manual total hip arthroplasty : a systematic review and meta-analysis. Bone Joint J. 2021; 103-B(6):1009-1020. DOI: 10.1302/0301-620X.103B6.BJJ-2020-1856.R1. View

Maryada V, Mulpur P, Kiran Eachempati K, Annapareddy A, Prasad V, Reddy A . Pre-operative planning and templating with 3-D printed models for complex primary and revision total hip arthroplasty. J Orthop. 2022; 34:240-245. PMC: 9478492. DOI: 10.1016/j.jor.2022.09.004. View

Barlow B, Oi K, Lee Y, Carli A, Choi D, Bostrom M . Outcomes of Custom Flange Acetabular Components in Revision Total Hip Arthroplasty and Predictors of Failure. J Arthroplasty. 2016; 31(5):1057-64. DOI: 10.1016/j.arth.2015.11.016. View

Choi H, Anderson D, Foster S, Beal M, Lee J, Barr C . Acetabular cup positioning in revision total hip arthroplasty with Paprosky type III acetabular defects: Martell radiographic analysis. Int Orthop. 2013; 37(10):1905-10. PMC: 3779547. DOI: 10.1007/s00264-013-2008-0. View

Durand-Hill M, Henckel J, Di Laura A, Hart A . Can custom 3D printed implants successfully reconstruct massive acetabular defects? A 3D-CT assessment. J Orthop Res. 2020; 38(12):2640-2648. DOI: 10.1002/jor.24752. View

Zhang Y, Gao Z, Zhang B, Du Y, Ma H, Tang Y . The application of custom-made 3D-printed titanium augments designed through surgical simulation for severe bone defects in complex revision total hip arthroplasty. J Orthop Traumatol. 2022; 23(1):37. PMC: 9357241. DOI: 10.1186/s10195-022-00656-5. View

Yu R, Hofstaetter J, Sullivan T, Costi K, Howie D, Solomon L . Validity and reliability of the Paprosky acetabular defect classification. Clin Orthop Relat Res. 2013; 471(7):2259-65. PMC: 3676616. DOI: 10.1007/s11999-013-2844-7. View

10.

Aprato A, Olivero M, Vergano L, Masse A . Outcome of cages in revision arthroplasty of the acetabulum: a systematic review. Acta Biomed. 2019; 90(1-S):24-31. PMC: 6503392. DOI: 10.23750/abm.v90i1-S.8081. View

11.

Weber M, Witzmann L, Wieding J, Grifka J, Renkawitz T, Craiovan B . Customized implants for acetabular Paprosky III defects may be positioned with high accuracy in revision hip arthroplasty. Int Orthop. 2018; 43(10):2235-2243. DOI: 10.1007/s00264-018-4193-3. View

12.

Yeroushalmi D, Singh V, Maher N, Gabor J, Zuckerman J, Schwarzkopf R . Excellent mid-term outcomes with a hemispheric titanium porous-coated acetabular component for total hip arthroplasty: 7-10 year follow-up. Hip Int. 2021; 33(3):404-410. DOI: 10.1177/11207000211040181. View

13.

Krishna P, Robinson D, Bucknill A, Lee P . Generation of hemipelvis surface geometry based on statistical shape modelling and contralateral mirroring. Biomech Model Mechanobiol. 2022; 21(4):1317-1324. PMC: 9283132. DOI: 10.1007/s10237-022-01594-1. View

14.

Pierannunzii L, Zagra L . Bone grafts, bone graft extenders, substitutes and enhancers for acetabular reconstruction in revision total hip arthroplasty. EFORT Open Rev. 2017; 1(12):431-439. PMC: 5367522. DOI: 10.1302/2058-5241.160025. View

15.

Baauw M, van Hooff M, Spruit M . Current Construct Options for Revision of Large Acetabular Defects: A Systematic Review. JBJS Rev. 2016; 4(11). DOI: 10.2106/JBJS.RVW.15.00119. View

16.

Wessling M, Gebert C, Hakenes T, Dudda M, Hardes J, Frieler S . Reconstruction of Paprosky III defects with custom-made implants: do we get them in the correct position? : short-term radiological results. Bone Joint J. 2022; 104-B(10):1110-1117. DOI: 10.1302/0301-620X.104B10.BJJ-2022-0508.R1. View

17.

Paprosky W, Perona P, Lawrence J . Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994; 9(1):33-44. DOI: 10.1016/0883-5403(94)90135-x. View

18.

Beswick A, Blom A . Bone graft substitutes in hip revision surgery: a comprehensive overview. Injury. 2011; 42 Suppl 2:S40-6. DOI: 10.1016/j.injury.2011.06.009. View

19.

Shichman I, Roof M, Askew N, Nherera L, Rozell J, Seyler T . Projections and Epidemiology of Primary Hip and Knee Arthroplasty in Medicare Patients to 2040-2060. JB JS Open Access. 2023; 8(1). PMC: 9974080. DOI: 10.2106/JBJS.OA.22.00112. View

20.

Romagnoli M, Grassi A, Costa G, Lazaro L, Presti M, Zaffagnini S . The efficacy of dual-mobility cup in preventing dislocation after total hip arthroplasty: a systematic review and meta-analysis of comparative studies. Int Orthop. 2018; 43(5):1071-1082. DOI: 10.1007/s00264-018-4062-0. View