Early results of revision acetabular endoprosthetics using individual designs

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Abstract

BACKGROUND: 3D-printed implants are one of the options for acetabulum reconstruction. The popularity of this technique is increasing every year.

AIM: To evaluate the early clinical, radiological and functional results of revision arthroplasty using individual acetabular components in patients with acetabulum bone defects.

MATERIALS AND METHODS: Revision endoprosthetics was performed in 50 patients. There were 36 female and 14 male patients. The patients’ mean age was 60.4±13.4 (23–89) years. According to the Paprosky classification, the defects in 1 case corresponded to type IIC, in 12 cases to type IIIA, in 37 cases to type IIIB, including 8 cases with violation of the acetabulum integrity. Hip joint function was assessed using the Harris Hip Score (HHS), pain severity using the Visual Analogue Scale (VAS), and social adjustment using the Western Ontario and McMaster Universities Arthritis Index (WOMAC).

RESULTS: Significant improvement was obtained on all assessment scales. The HHS score improved on average from 33.6 to 87.1 points, the VAS scale from 78.1 to 4.7 points, and the WOMAC from 75.8 to 11.6 points. There were 8 cases (21%) with complications in total. In one case with a violation of the acetabulum integrity we observed migration of the sciatic bone from the lower flange of the construct.

CONCLUSION: Thus, the results of the acetabulum reconstruction using individually fabricated acetabular components are promising.

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About the authors

Hovakim A. Aleksanyan

National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov

Author for correspondence.
Email: hovakim1992@mail.ru
ORCID iD: 0000-0002-6909-6624

MD, Cand. Sci. (Med.), Traumatologist-Ortopedist

Russian Federation, Moscow

Hamlet A. Chragyan

National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov

Email: chragyan@gmail.com
ORCID iD: 0000-0001-6457-3156
SPIN-code: 5580-8152

MD, Cand. Sci. (Med.), Traumatologist-Ortopedist

Russian Federation, Moscow

Sergey V. Kagramanov

National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov

Email: Kagramanov2001@mail.ru
ORCID iD: 0000-0002-8434-1915
SPIN-code: 4670-7747

MD, Dr. Sci. (Med.), Traumatologist-Ortopedist

Russian Federation, Moscow

Artem V. Ivanov

National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov

Email: dr.tomson@inbox.ru
ORCID iD: 0000-0002-6689-8947

MD, Traumatologist-Ortopedist

Russian Federation, Moscow

Konstantin Yu. Ukolov

National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov

Email: ukolov_doc@mail.ru
ORCID iD: 0000-0002-5479-3208

MD, Traumatologist-Ortopedist

Russian Federation, Moscow

Egor V. Polevoy

MEDSI Clinical Hospital in Botkinsky proezd

Email: poleegor@yandex.ru
ORCID iD: 0000-0002-2078-5410

MD, Cand. Sci. (Med.), Anesthesiologist

Russian Federation, Moscow

References

  1. Gwam СU, Mistry JB, Mohamed NS, et al. Current epidemiology of revision total hip arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty. 2017;32(7):2088–2092. doi: 10.1016/j.arth.2017.02.046
  2. Patel A, Pavlou G, Mújica-Mota RE, Toms AD. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J. 2015;97-B(8):1076–1081. doi: 10.1302/0301-620X.97B8.35170
  3. Kowalik TD, DeHart M, Gehling H, et al. The epidemiology of primary and revision total hip arthroplasty in teaching and nonteaching hospitals in the United States. J Am Acad Orthop Surg. 2016;24(6):393–398. doi: 10.5435/JAAOS-D-15-00596
  4. Yoon PW, Lee YK, Ahn J, et al. Epidemiology of hip replacements in Korea from 2007 to 2011. J Korean Med Sci. 2014;29(6):852–858. doi: 10.3346/jkms.2014.29.6.852
  5. Pivec R, Johnson AJ, Mears SC, Mont MA. Hip arthroplasty. Lancet. 2012;380(9855):1768–1777. doi: 10.1016/S0140-6736(12)60607-2
  6. Sullivan PM, MacKenzie JR, Callaghan JJ, Johnston RC. Total hip arthroplasty with cement in patients who are less than fifty years old. A sixteen to twenty-two-year follow-up study. J Bone Joint Surg Am. 1994;76(6):863–869. doi: 10.2106/00004623-199406000-00010
  7. Goodman SB, Adler SJ, Fyhrie DP, Schurman DJ. The acetabular teardrop and its relevance to acetabular migration. Clin Orthop Relat Res. 1988;(236):199–204.
  8. Emerson RH Jr, Head WC, Berklaich FM, Malinin TI. Noncemented acetabular revision arthroplasty using allograft bone. Clin Orthop Relat Res. 1989;(249):30–43.
  9. Zagorodniy NV, Chragyan GA, Aleksanyan OA, et al. 3D modelling and printing in primary and revision arthroplasty. N.N. Priorov Journal of Traumatology and Orthopedics. 2018;(2):21–29. (In Russ). doi: 10.32414/0869-8678-2018-2-21-29
  10. Kovalenko AN, Dzhavadov AA, Shubnyakov II, et al. Mid-term outcomes of using custom-made implants for revision hip arthroplasty. Traumatology and Orthopedics of Russia. 2019;25(3): 37–46. (In Russ). doi: 10.21823/2311-2905-2019-25-3-37-46
  11. Paprosky WG, Perona GP, Lawrence MJ. Acetabular defect classification and surgical reconstruction in revision arthoplasty, a 6 year follou-up evaluation. J Arthroplasty. 1994;9(1):33–43. doi: 10.1016/0883-5403(94)90135-x
  12. Gross AE, Blackley H, Wong P, et al. The use of allografts in orthopaedic surgery. Part II: the role of allografts in revision arthroplasty of the hip. J Bone Joint Surg Am. 2002;84-A(4):655–667.
  13. Cabanela ME, Trousdale RT, Berry DJ. Impacted cancellous graft plus cement it hip revision. Clin Orthop Relat Res. 2003;(417):175–182. doi: 10.1097/01.blo.0000096817.78689.ac
  14. Bozic KJ, Freiberg AA, Harris WH. The high hip center. Clin Orthop Relat Res. 2004;(420):101–105. doi: 10.1097/00003086-200403000-00014
  15. Moon JK, Ryu J, Kim Y, et al. Acetabular revision arthroplasty using press-fitted jumbo cups: an average 10-year follow-up study. Arch Orthop Trauma Surg. 2019;139(8):1149–1160. doi: 10.1007/s00402-019-03214-7
  16. Gibon E, Kerboull L, Courpied J, Hamadouche M. Acetabular reinforcement rings associated with allograft for severe acetabular defects. Int Orthop. 2019;43(3):561–571. doi: 10.1007/s00264-018-4142-1
  17. Hipfl C, Janz V, Löchel J, et al. Cup-cage reconstruction for severe acetabular bone loss and pelvic discontinuity: mid-term results of a consecutive series of 35 cases. Bone Joint J. 2018;100-B(11):1442–1448. doi: 10.1302/0301-620X.100B11.BJJ-2018-0481.R1
  18. Zagorodny NV, Alexanyan OA, Cragan GA, et al. Reconstruction of a hip socket using trabecular metal components. N.N. Priorov Journal of Traumatology and Orthopedics. 2019;(1):5–10. (In Russ). doi: 10.17116/vto20190115
  19. Tikhilov RM, Shubnyakov II, Chiladze IT, et al. Total hip joint endoproshetics using augments from trabecular metal in consequences of Fractures of the acetabulum. Traumatology and Orthopedics of Russia. 2011;(1):76–81. (In Russ).
  20. Christie MJ, Barrington SA, Brinson MF, et al. Bridging massive acetabular defects with the triflange cup: 2- to 9-year results. Clin Orthop Relat Res. 2001;(393):216–227. doi: 10.1097/00003086-200112000-00024
  21. Volokitina EA, Khabib MSS. Total hip replacement in cases of acetabular bone defects and deformations (review). Ural Medical Journal. 2018;(1):56–63. (In Russ).
  22. Holt GE, Dennis DA. Use of custom triflanged acetabular components in revision total hip arthroplasty. Clin Orthop Relat Res. 2004;(429):209–214. doi: 10.1097/01.blo.0000150252.19780.74
  23. Li H, Qu X, Mao Y, et al. Custom acetabular cages offer stable fixation and improved hip scores for revision THA with severe bone defects. Clin Orthop Relat Res. 2016;474(3):731–740. doi: 10.1007/s11999-015-4587-0
  24. Myncke I, van Schaik D, Scheerlinck T. Custom-made triflanged acetabular components in the treatment of major acetabular defects. Short-term results and clinical experience. Acta Orthop Belg. 2017;83(3):341–350.
  25. Gladnick BP, Fehring KA, Odum SM, et al. Midterm survivorship after revision total hip arthroplasty with a custom triflange acetabular component. J Arthroplasty. 2018;33(2):500–504. doi: 10.1016/j.arth.2017.09.026
  26. Citak M, Kochsiek L, Gehrke T, et al. Preliminary results of a 3D-printed acetabular component in the management of extensive defects. Hip Int. 2018;28(3):266–271. doi: 10.5301/hipint.5000561
  27. Sadovoy MA, Pavlov VV, Bazlov VA, et al. Potentialities of 3D-visualization in preoperative planning of primary and revision total hip arthroplasty. N.N. Priorov Journal of Traumatology and Orthopedics. 2017;3:37–42. (In Russ).
  28. Tikhilov RM, Shubnyakov II, Kovalenko AN, et al. Using custom triflange implant in revision hip arthroplasty in patient with pelvic discontinuity (case report). Traumatology and Orthopedics of Russia. 2016;22(1):108–116. (In Russ).
  29. Berasi CC, Berend KR, Adams JB, et al. Are custom triflange acetabular components effective for reconstruction of catastrophic bone loss? Clin Orthop Relat Res. 2014;473(2):528–535. doi: 10.1007/s11999-014-3969-z
  30. Berend ME, Berend KR, Lombardi AV, et al. The patient-specific triflange acetabular implant for revision total hip athroplasty in patients with severe acetabular defects: planning, implantation, and results. Bone Joint J. 2018;100-B(1 supple A):50–54. doi: 10.1302/0301-620X.100B1.BJJ-2017-0362.R1
  31. Barlow BT, Oi KK, Lee YY, et al. Outcomes of custom flange acetabular components in revision total hip arthroplasty and predictors of failure. J Arthroplasty. 2016;31(5):1057–1064. doi: 10.1016/j.arth.2015.11.016
  32. Korytkin AA, Novikova YaS, Morozova EA, et al. Custom triflange acetabular components for revision hip arthroplasty in the patients with severe acetabular defects: planning, surgical technique, outcomes. Traumatology and Orthopedics of Russia. 2020;26(2): 20–30. (In Russ). doi: 10.21823/2311-2905-2020-26-2-20-30
  33. Taunton MJ, Fehring TK, Edwards P, et al. Pelvic discontinuity treated with custom triflange component: a reliable option. Clin Orthop Relat Res. 2012;470(2):428–434. doi: 10.1007/s11999-011-2126-1
  34. Fröschen FS, Randau TM, Hischebeth GTR, et al. Mid-term results after revision total hip arthroplasty with custom-made acetabular implants in patients with Paprosky III acetabular bone loss. Arch Orthop Trauma Surg. 2020;140(2):263–273. doi: 10.1007/s00402-019-03318-0
  35. Kieser DC, Ailabouni R, Kieser SCJ, et al. The use of an Ossis custom 3D-printed tri-flanged acetabular implant for major bone loss: minimum 2-year follow-up. Hip Int. 2018;28(6):668–674. doi: 10.1177/1120700018760817
  36. Kovalenko AN, Tikhilov RM, Bilyk SS, et al. Positioning of individual acetabular components during hip revisions: do they really fit like a “key to a lock”? N.N. Priorov Journal of Traumatology and Orthopedics. 2017;(4):31–37. (In Russ).

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