Abstract
BackgroundThe aims of this pilot study were (1) to assess the efficacy of 3D-printed custom-made hemipelvic endoprosthesis in restoring the natural location of acetabulum for normal bodyweight transmission; (2) to evaluate the short-term function of the revision with this endoprosthesis and (3) to identify short-term complications associated with the use of this endoprosthesis.MethodsBetween February 2017 and December 2017, seven patients received revision with 3D-printed custom-made hemipelvic endoprosthesis. The body weight moment arm (BWMA) and cup height discrepancy (CHD) after primary and revisional surgery were analyzed to assess acetabulum location with plain radiography. After a median follow-up duration of 29 months (range 24–34), the function was evaluated with the Musculoskeletal Tumor Society (MSTS-93) score and Harris hip score (HHS). Complications were recorded by chart review.ResultsThe acetabulum locations were deemed reasonable, as evaluated by median BWMA (primary vs. revision, 10 cm vs. 10 cm) and median CHD (primary vs. revision, 10 mm vs. 8 mm). The median MSTS-93 score and HHS score were 21 (range 18–23) and 78 (range 75–82) after the revision. No short or mid-term complication was observed in the follow-up of this series.ConclusionsRevision with 3D-printed custom-made hemipelvic endoprostheses benefited in reconstructing stable pelvic ring and natural bodyweight transmission for patients encountering the aseptic loosening and fracture of modular hemipelvic endoprosthesis. The revision surgery and appropriate rehabilitation program improved patients’ function to a median MSTS score of 22 and pain-free ambulation. The incidence of the complications was low via this individualized workflow.
Highlights
The aims of this pilot study were (1) to assess the efficacy of Three dimensional (3D)-printed custom-made hemipelvic endoprosthesis in restoring the natural location of acetabulum for normal bodyweight transmission; (2) to evaluate the short-term function of the revision with this endoprosthesis and (3) to identify short-term complications associated with the use of this endoprosthesis
The body weight moment arm (BWMA) of the affected side decreased from a median of 10 cm after primary surgery to 8 cm; the cup height discrepancy (CHD) increased from a median of 10 mm after primary surgery to 14 mm
Function The deterioration of function was observed during the follow-up after primary surgery, and the improvement of function was observed after revision
Summary
The aims of this pilot study were (1) to assess the efficacy of 3D-printed custom-made hemipelvic endoprosthesis in restoring the natural location of acetabulum for normal bodyweight transmission; (2) to evaluate the short-term function of the revision with this endoprosthesis and (3) to identify short-term complications associated with the use of this endoprosthesis. Reported therapeutic options include a conservative method, partial retrieval of the endoprosthesis, total retrieval of the endoprosthesis followed by flail hip, and total retrieval of endoprosthesis followed by revision [2, 10, 11, 15]. The flail hip can restore partial lower-limb function, but limb length discrepancy and extended immobilization duration are unacceptable for some patients. Revision with a proper endoprosthesis is another potential method by offering immediate support to restore lower-limb function
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