De Angelis, Sara;
Di Laura, Anna;
Ramesh, Angelika;
Henckel, Johann;
Hart, Alister;
(2024)
The role of bone remodeling in measuring migration of custom implants for large acetabular defects.
Journal of Orthopaedic Research
10.1002/jor.25818.
(In press).
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Abstract
In revision total hip arthroplasty, achieving robust fixation is difficult and implant movement may occur over time. Bone may also rearrange around the implant as a result of mechanical loading, making the measurement of migration challenging. The study aimed to quantify changes in bone shape and implant position 1 year following acetabular reconstruction using custom three-dimensional-printed cups. This observational retrospective cohort study involved 23 patients with Paprosky type IIIB defects. Postop computed tomography scans taken within 1 week of surgery and at 1-year postsurgery were co-registered and analyzed. Three co-registration strategies were implemented including bone-to-bone and implant-to-implant. (1) Co-registration of the ipsilateral innominate bone (diseased anatomy) was used to measure changes in implant position. (2) Co-registration of the implant was carried out to quantify changes in the ipsilateral innominate bone shape. (3) Co-registration of the contralateral innominate bone (nondiseased anatomy) was performed to measure changes in the ipsilateral innominate bone shape and implant position. The median centroid distances (interquartile range [IQR]) were 2.3 mm (IQR: 3.7–1.7 mm) for changes in implant position, 2.4 mm (IQR: 3.6–1.6 mm) for changes in ipsilateral innominate bone shape, and 3.7 mm (IQR: 4.6–3.5 mm) for changes in ipsilateral innominate bone shape and implant position. Following acetabular reconstruction, implant movements and periprosthetic bone remodeling are physiological and of a similar extent. Surgeons and engineers should consider this when performing implant monitoring in these patients.
| Type: | Article |
|---|---|
| Title: | The role of bone remodeling in measuring migration of custom implants for large acetabular defects |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/jor.25818 |
| Publisher version: | http://dx.doi.org/10.1002/jor.25818 |
| Language: | English |
| Additional information: | Copyright © 2024 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Acetabular defect, biomechanical bone remodeling, custom implants, implant migration, Paprosky IIIB defect |
| UCL classification: | UCL 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/10188426 |
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