Customised three-dimensional printed revision acetabular implant for large defect after failed triflange revision cup

Zanasi, S.; Zmerly, Hassan

doi:10.1136/bcr-2019-233965

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…Laser selective sintering technology enables to manufacture implants with pore size control up to 20 microns [20,21,22].…”

Section: Discussionmentioning

confidence: 99%

Biological fixation of customized implants for post-traumatic acetabular deformities and defects

Bazlov,

Pronskikh,

Korytkin

et al. 2023

jour

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Introduction The number of surgical interventions using additive technologies in medicine has been growing both in Russia and with every year. Due to the development of printing customized implants, the use of standard (imported) designs has decreased by an average of 7 % in the provision of high-tech medical care. However, the issue of the pore size of customized implants for management of post-traumatic defects in the acetabulum remains open.Objective To evaluate the results of the treatment of patients with post-traumatic acetabulum defects and deformities with the implementation in clinical practice of customized implants with structure and size porous surface that are optimal from the point of view of biological fixation.Material and methods Porous implants with different types of porous structure were produced by direct laser sintering using Ti-6Al-4V titanium alloy powders. Experimental work was carried out in vitro to determine the ability of living fibroblasts to penetrate the pores of different sizes. Next, the clinical part of this study was conducted in order to determine the signs of biological fixation of customized acetabular implants in a group of patients (n = 30).Results The results of this experiment performed to analyze the penetration of living fibroblasts into the porous structure of implants with different pore size demonstrated that metal structures with a pore size of 400-499 μm can be singled out from all others. Discussion Analysis of the literature data shows that there is no consensus on the structure and size of the pores of a customized implant. In our work, we investigated the ability of human living fibroblasts to penetrate into the surface structure of a customized implant, as a result of which we determined their optimal pore size of 400-499 microns. It should be noted that this study was conducted for a definite anatomical location: the acetabulum. However, it cannot be excluded that the data obtained are relevant for other anatomical locations.Conclusion Management of bone defects in the acetabulum area with customized implants featuring the surface pore size of 400-499 microns is a justified and relevant method. A prerequisite for the use of such implants is strict compliance with the indications for their use, careful preoperative planning and correct positioning.

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“…Laser selective sintering technology enables to manufacture implants with pore size control up to 20 microns [20,21,22].…”

Section: Discussionmentioning

confidence: 99%

Biological fixation of customized implants for post-traumatic acetabular deformities and defects

Bazlov,

Pronskikh,

Korytkin

et al. 2023

jour

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“…Because this 3D-printing technology can fabricate the external appearance of the bone-augment material with a porous structure, the initial fixation of the implant with the bone is enhanced and the contact surface with the bone is widened. These elements enhance the long-term bond between the bone augment and the bone and induce a stable bond by stimulating bone growth [17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Design, fabrication, and structural safety validation of 3D-printable biporous bone augments

Kang

Lim²,

Sun

et al. 2022

Bio-des. Manuf.

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The use of commercial products such as a cup and liner for total hip arthroplasty for patients with severe bone defects has a high probability of failure. In these patients the cup alone cannot cover the bone defect, and thus, an additional augment or cage is required. In this study, we designed three-dimensional (3D) printable bone augments as an alternative to surgeries using reinforcement cages. Thirty-five sharp-edged bone augments of various sizes were 3D printed. A biporous structure was designed to reduce the weight of the augment and to facilitate bone ingrowth. Two types of frames were used to prevent damage to the augment’s porous structure and maintain its stability during printing. Furthermore, two types of holes were provided for easy augment fixation at various angles. Fatigue tests were performed on a combination of worst-case sizes derived using finite element analysis. The test results confirmed the structural stability of the specimens at a load of 5340 N. Although the porosity of the specimens was measured to be 63.70%, it cannot be said that the porous nature was uniformly distributed because porosity tests were performed locally and randomly. In summary, 3D-printable biporous bone augments capable of bonding from various angles and bidirectionally through angulation and bottom-plane screw holes are proposed. The mechanical results with bone augments indicate good structural safety in patients. However, further research is necessary to study the clinical applications of the proposed bone augment. Graphic abstract

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“…This increases the bonding force immediately after surgery and promotes bone growth, ensuring stable bonding of the implant. 14 , 15 , 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

Shape suitability and mechanical safety of customised hip implants: Three-dimensional printed acetabular cup for hip arthroplasty

Kang

Sun²,

Park³

et al. 2022

Journal of Orthopaedics

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Customised three-dimensional printed revision acetabular implant for large defect after failed triflange revision cup

Cited by 6 publications

References 16 publications

Biological fixation of customized implants for post-traumatic acetabular deformities and defects

Biological fixation of customized implants for post-traumatic acetabular deformities and defects

Design, fabrication, and structural safety validation of 3D-printable biporous bone augments

Shape suitability and mechanical safety of customised hip implants: Three-dimensional printed acetabular cup for hip arthroplasty

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