Custom-Made 3D-Printed Augments and Cages: An Effective Solution for Managing Severe Acetabular Bone Loss
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Updated: Jul 31, 2026
3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects
Published on: August 4, 2020
Adarsh Annapareddy1, Vijay C Bose2, Ameya Ajit Katariya1
1Department of Orthopaedic, Sunshine Bone and Joint Insitute, KIMS-Sunshine Hospitals, Hyderabad, Telangana, India.
Insights
Custom 3D-printed acetabular implants show promise for complex hip revision surgeries with severe bone loss. This approach offers a stable, effective solution for patients needing revision total hip arthroplasty.
Area of Science:
- Orthopedic surgery
- Biomaterials engineering
- Medical imaging
Background:
- Revision total hip arthroplasty (THA) is increasingly complex due to severe acetabular bone loss.
- Traditional acetabular augments and cages have high re-revision rates (up to 36% in 10 years).
- Paprosky type 3A and 3B defects present significant challenges in acetabular reconstruction.
Purpose of the Study:
- To explore the efficacy of custom-made 3D-printed acetabular augments and cages.
- To evaluate their use in managing severe acetabular bone loss during revision THA.
- To assess outcomes in patients with Paprosky grade 3 acetabular defects.
Main Methods:
- Retrospective case series of seven patients undergoing revision THA.
- Utilized 3D-computed tomography and custom virtual modeling for pre-operative planning.
- Employed custom-made 3D-printed titanium augments and cages, with a 10-day turnaround time.
Main Results:
- Average Harris hip score of 69.16 at final follow-up.
- No signs of implant loosening observed in the studied cases.
- Accurate implant placement confirmed by superimposing 3D models on radiographs.
Conclusions:
- Custom 3D-printed acetabular implants provide a reliable solution for severe bone loss in revision THA.
- This custom approach demonstrates potential for improved outcomes in complex acetabular reconstructions.
- Further research with larger cohorts and longer follow-up is warranted to confirm long-term efficacy.
Introduction:
Total hip arthroplasty (THA) is recognized as one of the most effective surgical procedures for the treatment of end-stage hip arthritis. However, the increasing number of primary THA cases has led to a corresponding rise in the frequency of revision surgeries, which are often more complex and challenging due to severe acetabular bone loss. In such cases, managing Paprosky type 3A and 3B defects requires precise implant design and advanced surgical techniques. Standard acetabular augments and anti-protrusio cages are commonly used, but they often fail to provide the necessary stability, leading to re-revision rates as high as 36% within 10 years. This case series explores the efficacy of custom-made 3D-printed acetabular augments and cages in managing severe acetabular bone loss during revision THA.
Materials And Methods:
This retrospective case series includes seven patients who underwent revision THA for Paprosky grade 3 acetabular bone loss between January 2023 and April 2024 at two high-volume tertiary care centers. The mean age of the patients was 45 years, with three males and four females included in the study. Pre-operative planning involved advanced imaging techniques, including 3D-computed tomography scans and custom virtual modeling, to design the acetabular components tailored to each patient's specific anatomical requirements.During the surgeries, custom-made 3D-printed titanium augments and cages were used. These implants were fabricated using in-house software, and the turnaround time from the decision to surgery was approximately 10 days. Post-operatively, the planned 3D model was superimposed on post-operative radiographs to assess implant placement accuracy. The Harris hip score at the final follow-up averaged 69.16, with no signs of implant loosening observed.
Conclusion:
Custom-made 3D-printed acetabular augments and cages offer a reliable and cost-effective solution for managing severe acetabular bone loss in revision THA. Despite the small sample size and short follow-up period, the results demonstrate the potential of these custom implants to improve outcomes in complex acetabular reconstructions. Further studies with larger sample sizes and longer follow-up periods are needed to confirm these findings and establish long-term efficacy.
