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Updated: May 11, 2026
3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects
Published on: August 4, 2020
Custom Three-Dimensional Printed Hemipelvis Reconstructions: Encouraging Early Results for Oncologic and Nononcologic
Matthew P Abdel1, Aaron R Owen1, Oliver B Dilger1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Background:
Additive manufacturing allows for the creation of custom acetabular components with unique shapes, geometries, and sizes for patients who have massive bone loss. The aim of the present study was to evaluate the implant survivorship, imaging results, and clinical outcomes of custom, three-dimensional (3D)-printed hemipelvis reconstructions in both the oncologic and nononcologic setting.
Methods:
We retrospectively identified seven total hip arthroplasties from 2018 to 2023 that utilized a novel ultraporous, custom, 3D-printed component. Indications for surgery were chondrosarcoma in three patients, aseptic loosening of the acetabular component in two patients, osteosarcoma in one patient, and reimplantation as part of two-stage revision for infection in one patient. All revision total hip arthroplasties had massive acetabular bone loss (Paprosky IIIB), and all primary neoplasm resections were Enneking-Dunham type III. The mean age was 56 years, 86% were men, and the mean body mass index was 33. The mean follow-up was four years (range, one to six).
Results:
At final follow-up, all ultraporous, 3D-printed constructs remained in situ. There was one patient revised to a constrained liner for dislocation and one other reoperation occurred for infection. There was an additional dislocation treated with a closed reduction. On radiographic and computed tomography images, the proximal portion of all components was osseointegrated to the ilium with no radiolucent lines. The inferior ischial flange had ingrowth failure in four cases. At the final follow-up, all patients were ambulatory (three without any gait aids, three patients who had a cane, and one who had a walker). There was no patient who died of disease, and there were no local recurrences.
Conclusions:
Ultraporous, custom, 3D-printed components used for hemipelvis reconstructions in salvage cases of arthroplasty and oncologic reconstruction demonstrated promising excellent early results with all osseointegrated to the ilium, all in situ to date, and all patients independently ambulatory. Dislocation continues to be the most common complication.
Level Of Evidence:
Level IV.
