A Custom-made Acetabular Implant for Paprosky Type 3 Defects

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Materials Science

Background:

• Acetabular revision surgery presents significant challenges, particularly in cases of major bone loss and compromised bone quality.
• Effective reconstruction requires precise defect analysis and robust implant design.

Purpose of the Study:

• To describe a detailed approach for acetabular defect analysis, including bone deficiency and quality assessment.
• To present the use of a custom-made titanium implant for acetabular reconstruction in complex cases.
• To evaluate the preliminary outcomes of this reconstructive technique.

Main Methods:

• Detailed defect analysis involving measurement of bone deficiency and assessment of bone quality.
• Design and implantation of a custom-made titanium acetabular component with flanges tailored to host bone (ilium, ischium, pubis).
• Consideration of bone quality for optimal screw fixation and implant purchase.

Main Results:

• Preliminary results from 12 retrospectively reviewed patients are promising.
• A minimum follow-up of 18 months was achieved for all reviewed patients.
• The custom implant design facilitated reconstruction in challenging acetabular defects.

Conclusions:

• The described approach for defect analysis and custom implant design offers a viable solution for acetabular revision with major bone loss.
• Custom titanium implants can effectively reconstruct acetabular defects, considering bone quality for secure fixation.
• Further investigation and long-term follow-up are warranted to confirm the durability and efficacy of this technique.