Evidence map›Paper›PMID 41074613›Full record

ArticleOrthopaedic surgery2025

Implantation Accuracy of Custom-Made Acetabular Components With Iliac Stem Fixation for Large Bone Defects in Hip Revision Surgery.

Timo A Nees, Mustafa Hariri, Christian T Müller, Moritz M Innmann, David M Spranz, Fabian Westhauser, Tilman Walker, Tobias Reiner

Abstract read
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Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Timo A NeesDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Mustafa HaririDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Christian T MüllerDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Moritz M InnmannDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
David M SpranzDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Fabian WesthauserDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Tilman WalkerDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Tobias ReinerDepartment of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.ORCID https://orcid.org/0000-0003-4563-6718

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe treatment of extensive acetabular bone defects presents significant challenges in revision total hip arthroplasty (rTHA). Custom-made implants, tailored to patient-specific anatomy via 3D printing, offer potential advantages regarding implant stability and alignment. Precise positioning of these large-volume implants is crucial for primary stability and long-term fixation, but can be surgically demanding, especially when intramedullary iliac press-fit stems are used. In contrast to triflange custom-made implants, data on the implantation accuracy of custom-made acetabular components with iliac stem fixation remain limited. This study aimed to assess the accuracy of implant positioning by comparing preoperatively planned component positions with postoperative radiographic outcomes, focusing on anteversion (AV), inclination (INCL), and the center of rotation (CoR).

methodsIn this retrospective cohort study, 24 patients with large acetabular defects (Paprosky ≥ 3A) underwent rTHA with custom-made acetabular components with intramedullary press-fit iliac stem fixation between November 2022 and April 2024. Implantation accuracy was evaluated by comparing the planned positions on preoperative CT scans with the actual implant positions observed on 6-week postoperative radiographs using a previously validated methodology. Discrepancies in AV, INCL, and the CoR were analyzed.

resultsA high degree of alignment with preoperative plans was observed. The mean postoperative AV was 9.96° ± 6.4° (planned: 10.2°), and the mean INCL was 46.3° ± 3.2° (planned: 44.6°). The deviations were minor (Δ AV: -0.25°, Δ INCL: 1.7°), confirming the precision of implant placement. Four implants had CoR deviations exceeding 5 mm cranially (mean cranial shift: 1.77 ± 3.97 mm), and five exceeded 5 mm laterally. Most deviations were within clinically acceptable ranges.

conclusionsOur findings demonstrate that custom-made acetabular components with iliac stem fixation can be implanted with high accuracy. Moreover, our results support the use of standard radiographs for the postoperative assessment of implant positioning precision. This study provides valuable insights into the accuracy of implant placement in complex rTHA cases, highlighting the role of patient-specific implant technologies in enhancing surgical outcomes.

Indexed as

AcetabulumArthroplasty, Replacement, HipHip ProsthesisIliumProsthesis DesignReoperationAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesTomography, X-Ray Computedacetabular defectsadditive manufacturingCTcustom‐made implantsPaprosky IIIpersonalized medicineradiographsrevisiontotal hip arthroplasty3D printing

Identifiers

PMID41074613
PMCPMC12580221

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.