Custom triflange revision acetabular components for significant bone defects and pelvic discontinuity: Early UK experience

We report our early experience in acetabular reconstruction for significant bone loss and pelvic discontinuity using custom triflange acetabular components. Retrospective consecutive review of all patients treated at our specialist tertiary unit with significant acetabular defects (Paprosky 3A/3B) and pelvic discontinuity who were reconstructed with custom triflange implants. The primary outcomes were radiographic failure and complications. 17 patients (17 hips) were included; 3 males/14 females with a mean age of 72 years (range 61–83). The average follow-up was 3.6 years (2–7 years). Bony defects were Paprosky 3B in 13/17 hips (76%) with pelvic discontinuity encountered in the majority of cases 15/17 hips (88%) and intra-pelvic failed components in 11/17 (64%). At final follow up, no radiographic failures were observed although three patients developed complications (17.6%); haematoma requiring washout out; intra-operative ilium fracture; and recurrent dislocation in one patient. Our experience suggest that acceptable outcomes can be achieved with custom implants for this group of challenging patients, although longer follow up is needed to monitor future implants’ failure.