Three dimensionalprinted titanium block to reconstruct severe acetabular bone defects in primary hip arthroplasty.

IF 2.6 3区医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2025-03-01 Epub Date: 2025-02-08 DOI:10.1007/s00264-025-06444-0

Han Sun, Rui Tan, Jiachen Liu, Shijie Shao, Jinghua Xiang, Shuxiang Li, Yijie Liu, Yimin Wang

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Abstract

Purpose: Total hip arthroplasty (THA) with severe acetabular bone defect remains a challenge in clinic. The purpose of this study is to investigate the treatment technique by using the three-dimensional (3D) printing technology, and analyze the feasibility and preliminary effect of 3D printed personalized titanium blocks for acetabular defect reconstruction in primary THA.

Methods: The clinical data of 35 patients with Paprosky type 3 acetabular defect, who underwent initial THA with 3D-printed titanium implants in our hospital from January 2017 to December 2019, were retrospectively analyzed. Among them, 21 cases were Paprosky type 3 A bone defects and 14 cases were Paprosky type 3B bone defects. The Harris Hip Score (HHS) was used to evaluate clinical outcomes, while imaging results were analyzed by hip rotation centres (V-COR and H-COR). In addition, postoperative complications were recorded.

Results: The mean follow-up was 79.4 months (ranging from 63 to 94 months) and no patient was lost to follow-up. The total in-hospital blood loss of all patients was 462.9 ± 227.8 mL, accompanied with a blood transfusion rate of 31.4%. HHS improved from 44.5 ± 10.0 preoperatively to 85.1 ± 7.4 at the last follow-up (p < 0.001). Postoperative X-rays exhibited a good match between the 3D-printed titanium block and the acetabulum. V-COR decreased from 50.1 ± 4.7 mm preoperatively to 19.7 ± 1.8 mm postoperatively (p < 0.001). Similarly, H-COR improved from 33.1 ± 11.8 mm preoperatively to 29.7 ± 1.7 mm postoperatively (p > 0.05). Additionally, there were no significant changes in V-COR and H-COR at the last follow-up (p > 0.05). During follow-up, three cases of complications were observed, including two cases of wound redness and one case of partial sciatic nerve paralysis.

Conclusions: The 3D-printed personalized titanium block revealed accurate reconstruction, satisfactory radiographic and clinical outcomes, and low complication rates. This technique provides a reliable treatment strategy for primary THA in patients with severe acetabular bone defect.

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三维打印钛块重建初次髋关节置换术中严重髋臼骨缺损。

目的：严重髋臼骨缺损的全髋关节置换术在临床上仍是一个难题。本研究旨在探讨三维（3D）打印技术的治疗技术，分析3D打印个性化钛块用于初级THA髋臼缺损重建的可行性及初步效果。方法：回顾性分析我院2017年1月至2019年12月35例首次行3d打印钛植入髋关节置换术的pasprosky 3型髋臼缺损患者的临床资料。其中Paprosky 3a型骨缺损21例，Paprosky 3B型骨缺损14例。Harris髋关节评分（HHS）用于评估临床结果，而影像学结果通过髋关节旋转中心（V-COR和H-COR）进行分析。并记录术后并发症。结果：平均随访时间为79.4个月（63 ~ 94个月），无失访病例。所有患者住院总失血量462.9±227.8 mL，输血率31.4%。HHS由术前44.5±10.0分改善至末次随访时85.1±7.4分（p < 0.05）。此外，最后一次随访时V-COR和H-COR无显著变化（p < 0.05）。随访中观察到3例并发症，其中2例创面红肿，1例部分坐骨神经麻痹。结论：3d打印个性化钛块重建准确，影像学和临床效果满意，并发症发生率低。该技术为严重髋臼骨缺损患者的原发性THA提供了可靠的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.