Hip revision arthroplasty for severe acetabular defects using custom 3D-printed porous titanium implants: Minimum...

Purposewas to evaluate the outcomes of custom 3D-printed trabecular titanium implants for acetabular revision total hip arthroplasty (rTHA) in patients with severe acetabular defects (Paprosky type 2 or 3) at minimum 2-year follow up.MethodsA prospective analysis was conducted on 10 patients (8 female) undergoing rTHA with custom 3D-printed titanium implants (3D-TTi), manufactured via laser sintering from Ti6Al4V titanium powder. At 1-year follow-up were measured the angles of inclination and anteversion, the vertical (VCOR) and horizontal (HCOR) center of rotation, and leg length difference (LLD). The Harris hip score (HHS) and Oxford hip score (OHS) was used. The mean follow-up period was of 36.4 (range 24.5-48.2) months, ensuring a maximum follow-up at 4 years.ResultsAll custom 3D-TTi (100%) in patients were positioned within the Lewinnek safe zone:. The COR was restored in all patients after rTHA. HCOR did not differ from the contralateral limb before and after rTHA. The VCOR was different before surgery, and after rTHA it did not differ due to correction by -6.9 mm. In 9 of 10 patients, the correction of the length of the operated limb did not exceed 4 cm, and the mean LLD after rTHA was 6.3 mm. One patient had a dislocation at 3 weeks. At 1-year follow-up, HHS (24.0±11.4 vs. 93.3±1.6) and OHS (8.1±2.6 vs. 41.3±4.1) were significantly improved (p=0.005).ConclusionAt a minimum follow-up of 2 years, none of the 3D-printed trabecular titanium implants required revision, indicating promising early implant stability and function in patients with severe acetabular defects.