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

Aims: We report our early experience in acetabular reconstruction for significant bone loss and pelvic discontinuity using custom triflange acetabular components. Patients and methods: 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. Results: 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%). M 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. Conclusions: 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.