Pelvic discontinuity treated with custom triflange component: a reliable option

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Medical device engineering

Background:

• Pelvic discontinuity is a frequent complication following total hip arthroplasty (THA).
• Current treatments include cup-cage constructs, acetabular allografts, pelvic distraction, and custom triflange components, with unclear advantages.
• Evaluating novel reconstructive techniques is crucial for improving patient outcomes.

Purpose of the Study:

• To determine revision and overall survival rates of custom triflange acetabular components for pelvic discontinuity.
• To assess the discontinuity healing rate and functional outcomes (Harris hip score).
• To compare the cost-effectiveness of custom triflange components against alternative reconstructive methods.

Main Methods:

• Retrospective review of 57 patients undergoing revision THA with custom triflange acetabular components.
• Analysis of operative reports, radiographs, and clinical data for outcomes.
• Cost comparison with other surgical techniques, with a minimum follow-up of 24 months.

Main Results:

• 98% of patients were free from revision for aseptic loosening; 95% free from revision of the triflange component.
• 49% achieved healed discontinuity without component migration; 81% had stable components with healed discontinuity.
• Average Harris hip score was 74.8; custom triflange implant cost was comparable to cup-cage constructs.

Conclusions:

• Custom triflange acetabular components demonstrate predictable mid-term fixation in patients with osteolytic pelvic discontinuity.
• This reconstructive approach offers favorable survival and healing rates.
• The cost of custom triflange implants is equivalent to other established treatment modalities.