Comparative Evaluation of Custom-Made Components and Standard Implants for Acetabular Reconstruction in Revision Total Hip Arthroplasty
- Authors: Murylev V.Y.1,2, Kukovenko G.A.1,2, Elizarov P.M.1,2, Rukin Y.A.3, Muzychenkov A.V.1,2, Rudnev A.I.4,5, Zhuchkov A.G.6, Alekseev S.S.6, Bobrov D.S.1,2, Germanov V.G.3
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Affiliations:
- Sechenov First Moscow State Medical Univesity
- S. P. Botkin Moscow City Clinical Hospital
- I.M. Sechenov First Moscow State Medical University (Sechenov University
- I.M.Sechenov First Moscow State Medical
- UniversityS. P. Botkin Moscow City Clinical Hospital
- S.P. Botkin Moscow City Clinical Hospital
- Issue: Vol 29, No 3 (2023)
- Pages: 18-30
- Section: Clinical studies
- URL: https://journal-vniispk.ru/2311-2905/article/view/255258
- DOI: https://doi.org/10.17816/2311-2905-2553
- ID: 255258
Cite item
Abstract
Background. The use of custom-made acetabular components is one of the promising methods for reconstruction of the acetabulum in cases of significant defects, including those associated with pelvic bone dissociation. It allows achieving stable fixation and restoring the biomechanics of the hip joint.
Aim of the study — to compare the results of using individually designed components, supportive antiprotrusion rings, augments, and hemispherical components in revision total hip arthroplasty for type IIIB bone defects according to Paprosky classification.
Methods. The study analyzed the treatment outcomes of 90 patients with type IIIB bone defects who underwent revision total hip arthroplasty between 2017 and 2022. Patients were divided into three groups: the first group received individually designed acetabular components, the second group received augments with hemispheres, and the third group had antiprotrusion cages implanted. The analysis included the reasons for revision surgery, operation duration, blood loss volume, and type of revision procedure. Pain and functional outcomes were assessed with WOMAC, Harris Hip Score, and VAS scales.
Results. 3D-printed constructs were more frequently implanted in patients with pelvic bone dissociation. The first group showed a significantly positive dynamic in functional outcomes. Complications were diagnosed in 27 (30%) cases: joint instability (dislocation) in 10 (11.1%) patients, periprosthetic infection in 8 (8.8%), aseptic loosening in 4 (4.4%), and sciatic nerve neuropathy in 5 (5.5%) patients. The number of these complications was higher in the second and third groups of patients.
Conclusion. Custom-made implants using 3D technologies are a preferable option for revision total hip arthroplasty in patients with type IIIB defects according to Paprosky classification, especially in cases of pelvic bone dissociation.
Full Text
##article.viewOnOriginalSite##About the authors
Valeriy Y. Murylev
Sechenov First Moscow State Medical Univesity; S. P. Botkin Moscow City Clinical Hospital
Author for correspondence.
Email: nmuril@yandex.ru
ORCID iD: 0000-0001-5753-8926
Professor, Doctor of medicine (Md, PhD), The head of Moscow City Joint arthroplasty center
Russian Federation, 8-2, Trubetskaya str., Moscow, 119991; 2nd Botkinsky pr-d, 2 5, 125284, MoscowGrigorii A. Kukovenko
Sechenov First Moscow State Medical Univesity; S. P. Botkin Moscow City Clinical Hospital
Email: gkukovenko@gmail.com
ORCID iD: 0000-0001-6700-0222
Cand. Sci. (Med.)
Russian Federation, 8-2, Trubetskaya str., Moscow, 119991; 2nd Botkinsky pr-d, 2 5, 125284, MoscowPavel M. Elizarov
Sechenov First Moscow State Medical Univesity; S. P. Botkin Moscow City Clinical Hospital
Email: elizarov_07@mail.ru
ORCID iD: 0000-0002-0217-2434
Cand. Sci. (Med.)
Russian Federation, 8-2, Trubetskaya str., Moscow, 119991; 2nd Botkinsky pr-d, 2 5, 125284, MoscowYaroslav A. Rukin
I.M. Sechenov First Moscow State Medical University (Sechenov University
Email: yar.rukin@gmail.com
ORCID iD: 0000-0001-7355-8556
Cand. Sci. (Med.)
Russian Federation, 8-2, Trubetskaya str., Moscow, 119991Alexey V. Muzychenkov
Sechenov First Moscow State Medical Univesity; S. P. Botkin Moscow City Clinical Hospital
Email: amuzychenkov@inbox.ru
ORCID iD: 0000-0002-3933-672X
Cand. Sci. (Med.)
Russian Federation, 8-2, Trubetskaya str., Moscow, 119991; 2nd Botkinsky pr-d, 2 5, 125284, MoscowAleksandr I. Rudnev
I.M.Sechenov First Moscow State Medical; UniversityS. P. Botkin Moscow City Clinical Hospital
Email: ruda310895@gmail.com
ORCID iD: 0000-0003-4490-2922
PhD applican
Russian Federation, 8-2, Trubetskaya str., Moscow, 11999;2nd Botkinsky pr-d, 2 5, 125284, MoscowAleksandr G. Zhuchkov
S.P. Botkin Moscow City Clinical Hospital
Email: Nas1674249@yandex.ru
ORCID iD: 0000-0002-6486-4567
Cand. Sci. (Med.)
Russian Federation, 2nd Botkinsky pr-d, 2 5, 125284, MoscowSemen S. Alekseev
S.P. Botkin Moscow City Clinical Hospital
Email: semen.alekseev.92@mail.ru
ORCID iD: 0000-0001-7599-7472
травматолог-ортопед
Russian Federation, 2nd Botkinsky pr-d, 2 5, 125284, MoscowDmitrii S. Bobrov
Sechenov First Moscow State Medical Univesity; S. P. Botkin Moscow City Clinical Hospital
Email: dsbmed@mail.ru
ORCID iD: 0000-0002-1190-7498
Cand. Sci. (Med.)
Russian Federation, 8-2, Trubetskaya str., Moscow, 119991; 2nd Botkinsky pr-d, 2 5, 125284, MoscowValeriy G. Germanov
I.M. Sechenov First Moscow State Medical University (Sechenov University
Email: valgers@mail.ru
ORCID iD: 0000-0002-1639-0555
Cand. Sci. (Med.)
Russian Federation, 8-2, Trubetskaya str., Moscow, 119991References
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