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Custom designed and 3D-printed titanium pelvic implants for acetabular reconstruction after tumour resection

Hip International, vol. 33, pp. 905–915

Abstract

Background: Reconstructive procedure following resection of large pelvic tumours around the hip joint remains a complex challenge. Methods: This study presents a retrospective case series of patients presenting with benign or malignant pelvic tumour for which an internal hemipelvectomy including the hip joint and subsequent reconstruction with a custom designed 3-dimensional printed titanium pelvic implant (3DPPI) has been performed between August 2013 and January 2018. Results: 15 consecutive patients with a median age of 33.9 years (IQR 26.4–72.2) and a median BMI of 20.7 kg/m 2 (IQR 19.0–33.3) were reviewed after median follow-up of 33.8 months (IQR 24.0–78.1). The majority of patients presented with a malignant tumour as their principal diagnosis ( n = 13, 86.7%). The median surgical time was 5.5 hours (IQR 4.5–8.5) and median peri-operative blood loss was 5000 ml (IQR 2000–10000). The median MSTS score at follow-up was 63.3% (IQR 51.7–86.7%). The median NRS in rest was 0.0 (IQR 0.0–5.0), the median NRS during activity was 2.0 (IQR 0.5–7.0) and the median HOOS-PS was 76.6% (IQR 67.9–91.0). 4 patients had implant-specific complications ( n = 4, 26.6%); 1 hip dislocation (Henderson type 1a), 3 structural complications (type 3a), 1 deep infection (type 4a) and 1 local tumour recurrence (type 5b). At follow-up, 4 out of 15 implants were classified as a failure, resulting in an implant survival rate of 73.3%. Conclusions: Acceptable peri-operative outcomes, functional results, complication rates and short-term implant survival can be achieved in a cohort of complex patients undergoing 3DPPI reconstruction after hemipelvectomy including the acetabulum.

Authors 5

  1. Demiën Broekhuis corresponding Aachen

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Centre, Leiden, The Netherlands

  2. Royal Prince Alfred Hospital

    Affiliation as printed

    Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

  3. Royal Prince Alfred Hospital

    Affiliation as printed

    Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, NSW, Australia

  4. Royal Prince Alfred Hospital

    Affiliation as printed

    Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

  5. Royal Prince Alfred Hospital

    Affiliation as printed

    Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

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References 45