JBJS - 2026-05-20 - Journal Article
Assessment of Custom-Made Acetabular Implants for Complex Revision Total Hip Arthroplasty: A Concise Follow-up, at a Minimum of 5 Years.
Di Laura A, Henckel J, Hart A
Topics
Key Takeaway
3D-printed custom-made acetabular implants achieved 96.3% implant survival at 9 years with 90% bone ingrowth and Oxford Hip Score improvement from 8 to 32 in complex revision THA.
Summary Depth
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Summary
This study evaluated long-term outcomes of 3D-printed custom-made acetabular implants (CMAIs) in 30 patients with complex revision THA at minimum 5-year follow-up. Radiographic analysis showed implant migration confined to the first postoperative year (≤5 mm) with bone ingrowth in 90% of patients. Nine-year implant survival was 96.3%, with OHS improving from 8 preoperatively to 32 at mid-term and remaining stable at final follow-up; complications included 2 dislocations in 1 patient, 1 transient sciatic nerve palsy, and recurrent infection in 2 patients.
Key Limitation
The n=30 sample is underpowered to detect differences in complication rates or survivorship across Paprosky defect subtypes, limiting generalizability of the 96.3% survival figure.
Original Abstract
UNLABELLED
In this study, we evaluated the long-term outcomes of 3D-printed, custom-made acetabular implants (CMAIs), expanding on earlier, mid-term findings. Radiographic assessment focused on implant migration and bone ingrowth, and clinical outcomes included survivorship, complications, the mobility score, and the Oxford Hip Score (OHS). The median follow-up was 7 years (range, 5 to 9 years). Thirty patients of diverse ethnic backgrounds (21 female; median age of 70 years) were included. Implant migration was limited to the first postoperative year (≤5 mm), with negligible displacement thereafter. Bone ingrowth occurred in 27 (90%) of the patients. The 9-year implant survival rate was 96.3%, with 1 re-revision for infection. The median OHS improved from 8 preoperatively (interquartile range [IQR], 4 to 13) to 32 (IQR, 21 to 37) at the previous, mid-term follow-up (p < 0.0001), and then remained essentially the same at the most recent follow-up. Mobility scores improved by a mean of 1.4 points (p < 0.0001). Two dislocations (in 1 patient), 1 transient sciatic nerve palsy, and recurrent infection in 2 patients were recorded. CMAIs provide durable fixation. Constructs stabilize over time, reflecting osseointegration.
LEVEL OF EVIDENCE
Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.