CUSTOM TRIFLANGE ACETABULAR COMPONENTS IN REVISION HIP REPLACEMENT (EXPERIENCE REVIEW)

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Abstract

Extensive defects of acetabulum especially accompanied by pelvis discontinuity at the level of acetabulum pose a serious challenge in revision hip replacement and create additional complexity in fixing the acetabular component. One of the perspective options to solve the above issue is the use of custom triflange acetabular components (CTAC) designed based on preoperative computer tomography given the specifics of bone defects of the patient. Purpose of the study — to evaluate the outcomes of CTAC use in revision hip replacement.

Materials and methods. The authors analyzed treatment outcomes of 12 patients after revision hip replacement using additive techniques of computer simulation and 3D printing CTAC. Follow up period after the surgery averaged 7±3 months (from one to ten months). 7 out of 12 patients had acetabular defects of Paprosky 3B type, 4 patients had defects of Paprosky 3A and in one patient — of Paprosky 2C.

Results. Two out of twelve patients had prosthesis dislocations that required revision hip surgery, one of those patients underwent open reduction of dislocation with wound debridement, another patient underwent replacement of articulating couple of acetabular component. Total scores under Harris Hip Score and paint VAS score prior to treatment was 28±7 and 7±1 points respectively, postoperative scores were 76±9 and 3±1 respectively.

Conclusion. The application of additive techniques for revision hip replacement in patients with extensive acetabular and pelvic defects allows to make a precise preoperative planning, to restore joint rotation center, to reconstruct bone defects and to securely fix triflange acetabular component that altogether significantly improve treatment outcomes and patients satisfaction with the surgery.

About the authors

A. A. Korytkin

Privolzhsky Federal Research Medical Centre

Email: fake@neicon.ru

Andrey A. Korytkin — Cand. Sci. (Med), Head of Department of Adult Orthopedics.

18, Verkhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603155

Russian Federation

D. V. Zakharova

Privolzhsky Federal Research Medical Centre

Email: fake@neicon.ru

Daria V. Zakharova — Graduate Student.

18, Verkhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603155

Russian Federation

Ya. S. Novikova

Privolzhsky Federal Research Medical Centre

Author for correspondence.
Email: novikova_jana@mail.ru

Yana S. Novikova — Cand. Sci. (Biol), Junior Researcher.

18, Verkhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603155

Russian Federation

R. O. Gorbatov

Privolzhsky Federal Research Medical Centre

Email: fake@neicon.ru

Roman O. Gorbatov — Head of Laboratory of Additive Technologies.

18, Verkhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603155 Russian Federation

K. A. Kovaldov

Privolzhsky Federal Research Medical Centre

Email: fake@neicon.ru

Kirill A. Kovaldov — Graduate Student.

18, Verkhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603155

Russian Federation

Y. M. El Moudni

Privolzhsky Federal Research Medical Centre

Email: fake@neicon.ru

Younes M. El Moudni – resident.

18, Verkhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603155

Russian Federation

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