Применение индивидуальных вертлужных компонентов в эндопротезировании тазобедренного сустава при посттравматическом коксартрозе

Abstract

Introduction The increase in the number of primary hip joint arthroplasties leads to a steady increase in revision interventions. The category of complex arthroplasty also includes patients with extensive acetabular injuries due to high-energy trauma. Amplification of clinical cases requires an individual approach when planning the configuration of the acetabular component. In recent years, clinics have been actively introducing into practice the technology of 3D-modeling of hip replacement components. The purpose of the study was to assess the short and medium-term results of hip joint arthroplasty in posttraumatic coxarthrosis with significant bone defects, using individual acetabular components, with the presentation of clinical cases. Material was five arthroplasty cases operated using customized implants produced with a 3D printer. All five patients were males of working age who suffered high-energy injuries. Three of them had previous operations on the hip joint (from 1 to 5 operations). Anamnesis, characteristics of patients, bone defects types by Paprosky, follow-ups after surgery, X-ray data, the dynamics of the quality of life on the Harris scale were studied. Personalized acetabular components produced on a 3D printer were successfully implanted in four patients; in one case, the installation failed due to excessive lateralization of the rotation center and technical difficulties in adjusting the implant head. The follow-up period of three patients was 16.7 ± 3.7 months; two had operations three and 4 months ago respectfully. Results Dynamic assessment on the Harris scale in all patients showed an increase from 26 ± 5.2 to 77 ± 6.6 points. X-ray monitoring revealed a stable position of the implant components with satisfactory bone integration. Conclusion The study showed good short-and mediumterm results of the use of customized acetabulum components manufactured using a 3D printer in patients with significant bone defects of the acetabulum on the background of post-traumatic coxarthrosis.