Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 26290
SEVERE ACETABULAR REVISION SURGERY: A PERSONALIZED APPROACH
Frederik GELAUDE 1 , Michiel MULIER 2 , Martijn RAAIJMAKERS 2 , An WILLEMS 1 , Tim
CLIJMANS 1
1 Mobelife, Leuven (BELGIUM), 2 Department of Reconstructive Hip Surgery, UZ
Pellenberg, University Hospitals Leuven, Pellenberg (BELGIUM)
Introduction - A patient-specific approach could prove valuable to deal with
challenges such a massive bone loss and multiple revisions of the hip. Stably and
thus sustainably restoring patient’s mobility is the major goal of a surgical
reconstruction. A patient-central view is maintained during the complete implant
development process. Materials and methods - The implant concerned, supporting
the acetabular component consists of a round cup with a number of flanges and is
designed based on the CT-data and anatomical bone reconstruction. In case of
significant pelvic bone loss, the flanges bypass the bony defects and extend onto the
major bones of pelvis. A porous structure fills the bone defect; a thin porous layer is
present at the interface between the implant and the bone. Optimal screw positions
and lengths are pre-operatively assessed based on bone quality, and transferred into
surgery using jig guiding technology. Cup orientation is anatomically analyzed for
inclination and anteversion angles. A fully individualized muscle modeling and finite
element simulation allows for patient-specific analysis of mechanical implant integrity
and interaction with the surrounding bone. Limited throughput time and design
flexibility is maintained by certified titanium additive manufacturing. Results -
Currently, three clinical cases were successfully operated and show good short-term
follow-up results; other are in preparation. These were designed in close
collaboration with the surgeon. Personalized case documentation was incorporated,
both as booklet and in poster format for intra-operative referencing. Conclusion - A
completely personalized process of acetabular implant design features unique
restoration in terms of anatomy, stability and mobility.
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