Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2022; 89(6):423-428 | DOI: 10.55095/achot2022/067

Klinický výsledek individuálně vyrobených implantátů u primární a revizní artroplastiky kyčlePůvodní práce

P. WINTER^1,2,*, K. KURZ¹, A. JUNG¹, J. ROCH¹, M. WOLF², T. SIEBEL¹

¹ Knappschaft Hospital Puettlingen, Department of Orthopedics and Trauma Surgery, Puettlingen, Germany

² Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany

PURPOSE OF THE STUDY:
Facing the increasing number of priary and revision hip arthroplasties, the therapy of complex osseus defects becomes a crucial issue. Large acetabular defects cannot be treated with standard implant. Individual, customized implants based on 3D computed tomography (CT) scans are used for reconstruction. However, high complication and revision rates come along with final favorable outcomes.

MATERIAL AND METHODS:
Eight patients underwent primary or revision total hip arthroplasty by an anterolateral surgical approach using patient matched implants based on 3D CT scans. Six patients with a Paprosky type IIIB acetabular defect, one patient with a non-union acetabular and femoral neck fracture and one patient with a severe hip dysplasia were included. The clinical data and the Merle d'Aubigné score assessing the clinical outcome pre- and postoperatively were analyzed retrospectively.

RESULTS:
Patient matched implants were used for eight patients (four male and four female). The mean Merle d'Aubigné score improved from 8.1 (range 2-11) pre-operatively to 13 (range 9-17) at the final follow-up (p < 0.01). Postoperative complications were recorded in 3 cases.

CONCLUSIONS:
Customized implants of severe acetabular defects provide a solution with a favorable outcome. Nevertheless, dislocation presents a significant complication. A reduction of complications in order to achieve the optimal custome-made implant is desirable.

Klíčová slova: revision arthroplasty, patient-matched implants, Paprosky IIIB defects, clinical outcome

Zveřejněno: 15. prosinec 2022  Zobrazit citaci