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Can custom 3D printed implants successfully reconstruct massive acetabular defects? A 3D-CT assessment

Durand-Hill, M; Henckel, J; Di Laura, A; Hart, AJ; (2020) Can custom 3D printed implants successfully reconstruct massive acetabular defects? A 3D-CT assessment. Journal of Orthopaedic Research , 38 (12) pp. 2640-2648. 10.1002/jor.24752. Green open access

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Abstract

We report on the accuracy, measured with three-dimensional (3D) computed tomography (CT) postoperatively, in positioning custom 3D printed titanium components in patients with large acetabular defects. Twenty patients (13 females and 7 males) received custom-made acetabular implants between 2016 and 2018; the mean age was 66 years (SD = 11.6) and their mean body mass index was 28 (SD = 6.1). The median time to follow up was 25.5 months, range: 12 to 40 months. We describe a comparison method that uses the 3D models of CT-generated preoperative plans and the postoperative CT scans to quantify the discrepancy between planned and achieved component positions. Our primary outcome measures were the 3D-CT-measured difference between planned and achieved a component position in six degrees of freedom: center of rotation (CoR), component rotation, inclination (INC), and version (VER) of the cup. Our secondary outcome measures were: Oxford hip score, walking status, and complication rate. All components (100%) were positioned within 10 mm of planned CoR (in the three planes). Eighteen (95%) components were not rotated by more than 10° compared to the plan. Eleven (58%) components were positioned within 5° of planned cup angle (INC and VER). To date one complication has occurred, a periprosthetic fracture. This is the largest study in which postoperative 3D-CT measurements and clinical outcomes of custom-made acetabular components have been assessed. Accurate pre-op planning and the adoption of custom 3D printed implants show promising results in complex hip revision surgery.

Type: Article
Title: Can custom 3D printed implants successfully reconstruct massive acetabular defects? A 3D-CT assessment
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/jor.24752
Publisher version: https://doi.org/10.1002/jor.24752
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: computed tomography, custom 3D printed implants, image analysis for component orientation, paprosky acetabular defects, revision Hip surgery
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
URI: https://discovery.ucl.ac.uk/id/eprint/10108029
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