Abstract
Background:
Massive acetabular defects remain an unresolved challenge in revision arthroplasty surgery of the hip. We report on 7 patients treated with custom made acetabular components to manage these massive boney defects.
Methods:
After high resolution CT scans were done, custom made implants were designed in collaboration between the surgeons and the manufacturer. All implants matched the bony defects as designed.
Results:
There were 6 female and 1 male patients. The average age was 54 years, and on average each patient had had 9 previous revision procedures to the hip. All had Paprosky type 111B defects.
The average surgical time for the procedure was 2.6 hours. The average time in hospital post-operation was 6 days. The average follow-up post index procedure was 13 months.
Two implants needed to be explanted because of sepsis. One device was re-implanted after the infection was eradicated. One patient needed re-operation because of recurrent dislocations. All 6 surviving implants have remained well fixed with no radiological evidence of loosening.
We did a cost analysis including the cost of the previous revision procedures, the cost of alternative acetabular hardware constructs, and the cost of the custom made implants. These custom made implants are cost effective in the clinical setting
Conclusion:
Massive acetabular bony defects remain an ongoing challenge, and we have presented a viable option in respect of these cases which is cost effective and durable in the short term
