REVISION HIP ARTHROPLASTY WITH CUSTOM TRIFLANGE IMPLANT IN PATIENT WITH PELVIC DISCONTINUITY (case report)

The most challenge of the revision hip arthroplasty is pelvic discontinuity (defect type IV by AAOS classification). In such cases it is very difficult to provide secure fixation of the acetabular component due to limited contact with host bone and mobility of bone fragments. Custom triflange acetabular components(CTAC) is a perspective method of patient management in this cases. CTACs are designed based on preoperative CT scans to build a custom titanium 3D-printed implant to address the patient's specific bone defect and provide secure fixation in the ilium, pubis, and ischium. We present case report of the patient - female 48 years old with aseptic loosening of the acetabular component and pelvic discontinuity. Chronic pelvis discontinuity developed due to conservative treatment of the associative fracture of the acetabulum. Four years after injury total hip arthroplasty using Burch-Schneider.age was performed. After seven years - aseptic loosening of the acetabular component and revision surgery with antiprotrusion revision implant. In two years after last surgery - aseptic loosening of the acetabular component and extensive ilium bone defect along with caudal hip bone part medial displacement and pelvic ring deformity. Due to high difficulty of revision total hip arthroplasty using modular acetabular cup and antiprotrusion implants we perform replacement with custom triflange acetabular component