USING CUSTOM TRIFLANGE IMPLANT IN REVISION HIP ARTHROPLASTY IN PATIENT WITH PELVIC DISCONTINUITY (CASE REPORT)

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Abstract

Revision hip arthroplasty rate is growing, and pelvic discontinuity rate ranges from 1% to 5% of acetabular component revision reasons. According to AAOS acetabular defects classification, pelvic discontinuity is fourth type defect in which cranial part of hip bone is separated from caudal part at acetabular level. Usually it occurs from bone loss secondary to osteolysis, infection, fracture or aseptic loosening. There are a lot of techniques for pelvis discontinuity treatment. Published results of bulk allografts and antiprotrusion cages have generally been poor. More preferable methods with acceptable rate of good results are cup-cage systems and custom triflange acetabular components(CTAC). CTACs are designed based on preoperative CT scans to build a custom titanium 3D-printed implant to address the patient's specific bone defect and provide secure fixation in the ilium, pubis, and ischium. We faced pelvic discontinuity, in which extensive iliac bone loss was added to caudal hip bone part medial displacement and pelvic ring deformity, in patient with multiple hip surgeries. Preoperative investigation called into question the possibility of using off-the-shelf hip implants, which could restore the biomechanics of the hip and provide reliable primary fixation at the same time. We present case report of the patient with pelvic discontinuity and massive bone loss treatment using a custom triflange component.

About the authors

R. M. Tikhilov

Vreden Russian Research Institute of Traumatology and Orthopedics, Mechnikov North-Western State Medical University

Email: fake@neicon.ru
director Russian Federation

I. I. Shubnyakov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru
Academic Secretary Russian Federation

A. N. Kovalenko

Vreden Russian Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: tonnchik@ya.ru
researcher Russian Federation

C. C. Bilyk

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru
researcher Russian Federation

A. N. Tsybin

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru
researcher Russian Federation

A. O. Denisov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru
head of scientific department Russian Federation

G. D. Dmitrevich

Saint Petersburg Electrotechnical University

Email: fake@neicon.ru
professor of computer-aided design system department Russian Federation

P. N. Vopilovsky

Peter the Great Saint-Petersburg Polytechnic University

Email: fake@neicon.ru
director of NTK «Machine Technology» Russian Federation

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