Monoflanged Custom-Made Acetabular Components Promote Biomechanical Restoration of Severe Acetabular Bone Defects by Metallic Defect Reconstruction

Walter, Sebastian; Randau, Thomas M.; Gravius, Nadine; Gravius, Sascha; Fröschen, Frank Sebastian

doi:10.1016/j.arth.2019.10.040

Cited by 19 publications

(7 citation statements)

References 24 publications

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“…Others reported satisfying final position of the implants, inclination of the shell or osseointegration, but did not investigate offsets and COR [ 28 , 29 ]. A recently published study by Walter et al showed significant lateralisation and cranialization when CTAC was used [ 30 ]. This study cannot confirm these findings as shown above.…”

Section: Discussionmentioning

confidence: 99%

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Gruber¹,

Jesenko

Burghuber³

et al. 2020

BMC Musculoskelet Disord

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Background Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects. Methods Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics. Results The mean follow-up time of the nine patients was 12.2 months (range: 10–18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset. Conclusions The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined. Level of evidence Therapeutic Level IV.

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Section: Discussionmentioning

confidence: 99%

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Gruber¹,

Jesenko

Burghuber³

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Others reported satisfying nal position of the implants, inclination of the shell or osseointegration, but did not investigate offsets and COR (28,29). A recently published study by Walter et al showed signi cant lateralisation and cranialization when CTAC was used (30). This study cannot con rm these ndings as shown above.…”

Section: Discussionmentioning

confidence: 66%

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Gruber

Jesenko²,

Burghuber³

et al. 2020

Preprint

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Background Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects.Methods Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics.Results The mean follow-up time of the nine patients was 12.2 months (range: 10 - 18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset.Conclusions The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined.Level of Evidence: Therapeutic Level IV.

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“…In the case of the first revision, the surgeon often still has sufficient bone stock available in which the respective defect situation can be managed with standard implants. In contrast, multiple revision operations or anatomical anomalies, such as hip dysplasia, often require so-called jumbo cups, reinforcement rings, modular cups with augments, flanged implants and patient-specific 3D-printed implants [3][4][5][6][7]. In addition to a stable anchorage in the remaining bone stock, the aim here is to reconstruct the centre of rotation as closely as possible to the original anatomy [8].…”

Section: Introductionmentioning

confidence: 99%

Defining the canal for ischial and pubic screws in cup revision surgery

Brodt

Boersch

Strube

et al. 2022

International Orthopaedics (SICOT)

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Purpose When revising acetabular cups, it is often necessary to provide additional stabilisation with screws. In extensive defect situations, the placement of screws caudally in the ischium and/or pubis is biomechanically advantageous. Especially after multiple revision operations, the surgeon is confronted with a reduced bone stock and unclear or altered anatomy. In addition, screw placement caudally is associated with greater risk. Therefore, the present study aims to identify and define safe zones for the placement of caudal acetabular screws. Methods Forty-three complete CT datasets were used for the evaluation. Sixty-three distinctive 3D points representing bone landmark of interests were defined. The coordinates of these points were then used to calculate all the parameters. For simplified visualisation and intra-operative reproducibility, an analogue clock was used, with 12 o’clock indicating cranial and 6 o’clock caudal. Results A consistent accumulation was found at around 4.5 ± 0.3 hours for the ischium and 7.9 ± 0.3 hours for the pubic bone. Conclusions The anatomy of the ischium and pubis is sufficiently constant to allow the positioning of screws in a standardised way. The interindividual variation is low — regardless of gender — so that the values determined can be used to position screws safely in the ischium and pubis. The values determined can provide the surgeon with additional orientation intra-operatively when placing caudal acetabular screws.

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Monoflanged Custom-Made Acetabular Components Promote Biomechanical Restoration of Severe Acetabular Bone Defects by Metallic Defect Reconstruction

Cited by 19 publications

References 24 publications

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Defining the canal for ischial and pubic screws in cup revision surgery

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