Affiliations: [a] Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany | [b] Department of Traumatology and Orthopaedic Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain | [c] Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey | [d] Orthopaedics Northeast, Fort Wayne, IN, USA
Correspondence:
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Corresponding author: Ainhoa Álvarez Valdivielso, Department of Traumatology and Orthopaedic Surgery, Hospital Universitario Son Espases, 07010 Palma de Mallorca, Balearic Islands, Spain. E-mail: aalvarez.valdivielso@gmail.com.
Abstract: BACKGROUND: Surgeons still face difficulties when performing aseptic acetabular revision on patients with extensive defects. Advances in three-dimensional printing technology (3DP) have afforded to the surgeons to create a patient-specific implant matching the morphology and topography of the defect. OBJECTIVE: The aim of the current research was to determine the survivorship in the treatment of acetabular bone defects with pelvic discontinuity (PD). METHODS: In order to reconstruct Paprosky type III defects with PD, twenty-three patients underwent revision total hip arthroplasty (THA) utilizing 3D-printed implants (Mobelife). The primary outcomes were the implant-associated failure rate correlated with survivorship. As secondary variables, complications and the effect of age, sex, comorbidities, history of infections and the presence of other lower limb arthroplasties on a new revision were analyzed. RESULTS: Patients were followed out to a mean of 67.22 ± 39.44 months (range, 0.9–127 months). Mobelife implant mean survival was 102.57 ± 9.90 months (95% CI 83.17–121.96). The cohort’s implant one-year survival rate was 87%; at ten years, it dropped to 78.3%. There were four revisions: three due to periprosthetic joint infection (PJI) and one case due to aseptic loosening. Cox regression analysis did not identify any variable as predictor of failure. CONCLUSION: The use of 3DP patient-specific acetabular components has shown encouraging results and it is a viable treatment option for addressing acetabular defects with combined PD in aseptic THA revision.
Keywords: Acetabular bone loss, Paprosky type III bone defect, pelvic discontinuity, patient-specific implants, 3D printing
