Analysis Of The Efficacy Of Custom Triflange Cup In The Treatment Of Paprosky Ⅲ Acetabular Defect

Objective:Massive acetabular bone defects are a major challenge in revision total hip arthroplasty,and survival rates after revision with extensive bone loss remain unsatisfactory.The purpose of this study was to analyze the use and efficacy of a custom triflange cup in Paprosky Ⅲ acetabular bone defects.Methods:A total of 20 patients(21 hips)underwent hip revision with a custom triflange cup between September 2018 and August 2022.The patients’age,body mass index(BMI),operation time,blood loss,and complications were recorded.Harris score and visual analogue scale(VAS)were used to assess the functional recovery and pain of the hip joint.And the relevant data were analyzed retrospectively.Radiographs and computed tomography(CT)scans were used to assess the placement of the custom triflange cup and measure the anteversion and abduction angles of the custom triflange cup.Harris functional scores and VAS pain scores before surgery were compared with those at the final follow-up using a paired t-test.One-sample t-test was used for comparison of postoperative custom triflange cup anteversion and abduction angles with preoperative design angles.Results:A total of 20 patients(21 hips)were included in the study,12 men(60%)and8 women(40%).The average follow-up time was 22 months(3-50),the average operation age was 57 years(36-77),the average BMI index was 23.6kg/m~2(21.2-25.7),the average operative time was 324 minutes(193-480),and the average blood loss was 1206 ml(600-2000).In 20 patients(21 hips),the prosthesis did not show any loosening of imaging,and the survival rate of the prosthesis was 100%,with no prosthesis-related complications.2 cases had intraoperative sciatic nerve injury,which gradually recovered.And 2 cases had fat liquefaction in the incision,which healed smoothly after debridement and drainage.All patients had good recovery of hip function.The Harris hip function score at the final follow-up was(77.86±6.11)and the VAS pain score was(1.95±0.97),both with statistically significant differences compared with the preoperative period(t=34.274,P<0.05;t=-23.819,P<0.05).The abduction angle of the acetabular prosthesis was(44.52°±1.44)and the anteversion angle was(19.24°±2.19),and the differences were not statistically significant when compared with the preoperative design angle(t=-1.52,P>0.05;t=-1.59,P>0.05).Conclusion:The use of custom triflange cup for the treatment of severe acetabular bone defect of Paprosky Ⅲ showed a satisfactory result.The early survival rate of the custom triflange cup was 100%,with no prosthesis-related complications.Patients had good functional recovery of the hip joint and high clinical satisfaction,making it a reliable treatment option.Future studies with larger sample sizes and longer follow-up periods will be conducted to evaluate the long-term effectiveness of using custom triflange cup.