Vol. 11 | Issue 1 | January-February 2023 | Page: 17-19 | Lakshith B R, Adarsh U Tuppad, Shashiraj K Shetty, Edward L Nazareth, Kumar Mihir

DOI: https://doi.org/10.13107/jkoa.2023.v11i01.059

Authors: Avinash P [1], Karthik Sangani [1], Pavith Janardhan T [1], Prajwal KN [1], Ajay Krishna, Prajwal K [1]

[1] Department of Orthopaedics, Sanjay Gandhi Institute of Orthopaedics and Trauma, Bengaluru, Karnataka, India.

Address of Correspondence

Dr. Karthkik Sangani
Orthopaedic Surgeon, Department of Orthopaedics, Sanjay Gandhi Institute of Orthopaedics and Trauma, Bengaluru, Karnataka, India.
E-mail: mrbonesthehealer@gmail.com

Abstract

Introduction: THR is one of the commonly performed adult arthroplasties in the world. Over the past 6 decades, Charnley low friction arthroplasty has evolved in design and concept. One among those recent advances is the use of 3D printing technology in arthroplasties. Purpose of this article is to discuss and share the details of a hip arthroplasty case where a customized 3D printed acetabulum component was used.

Case: A 3 year postop case of acetabulum fracture fixation presented with arthritis of hip. CT revealed a periacetabular massive bone loss. After considering all options, decision was made to use a 3D printed acetabulum shell.

Discussion: Complex THRs with special instrumentation and augmented implants are frequently seen in revision surgeries and post acetabulum fracture cases. Based on the size and pattern of the defect, IlioIschial cages, Triflange cups, Trabecular metal augments, CupCage constructs, Jumbo cups are some common options at a surgeons disposal while tackling an acetabulum bone loss challenge. A 3D manufactured component can be of aid when the defect is too large. It gives the advantage of being anatomically contoured. It also allows a porous structure for bone ingrowth.

Conclusion: Life size models of the pelvis and the component gives an explicit simulation of the surgery, including the component placement and trajectory of the screws. This effective preoperative planning can improve the surgical precision and reduce the complications. Literature on the survival rates and long term complications of such 3d printed acetabulum shells is limited. Studies on the long term outcomes with usage of these implants would be insightful
Keywords: 3D Printing, Complex THR, Customised acetabular shell

References

1. Madhu R et al. Outcome of surgery for reconstruction of fractures of the acetabulum—the time-dependent effect of delay. J Bone Joint Surg.2006; 86B:1197–1203.
2. Giannoudis P.Operative treatment of displaced fractures of the acetabulum: a meta-analysis. J Bone Joint Surg Br.2005; 87(1):2–9.
3. Telleria JJM, Gee AO. Classifications In Brief: Paprosky Classification of Acetabular Bone Loss. Clinical Orthopaedics & Related Research. Ovid Technologies (Wolters Kluwer Health); 2013; 471: 3725–30.
4. Sing S et al. Laser and electron-beam powder-bed additive manufacturing of metallic implants: A review on processes, materials and designs. J. Orthop. Res. 2016; 34:369–385.
5. Restrepo S, Smith EB, Hozack WJ. Excellent mid-term follow-up for a new 3D-printed cementless total knee arthroplasty [Internet]. The Bone & Joint Journal. British Editorial Society of Bone & Joint Surgery. 2021; 103B:32–7.

                                          (Abstract Text HTML)      (Download PDF)