Resumen

TRONCOSO, Ignacio; SABATELLA, Carlos  y  BLANCO O´DENA, Gonzalo J.. Utilización de cotilos 3D en defectos acetabulares graves. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2022, vol.87, n.5, pp.676-684. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2022.87.5.1567.

Introduction: Given the increase in hip arthroplasties in the last century, serious acetabular defects are increasingly frequent events. Their treatment represents a real challenge, due to the bone deficit and poor bone quality that these patients usually present. Materials and Methods: Six patients treated between 2016 and 2021 are presented. Five cases of pelvic discontinuity due to failed revisions, classified as Paprosky type IIIB, and one transverse fracture of the acetabulum, a possible treatment option in cases of osteoporotic patients. Results: The patients treated with this multidisciplinary technique were followed up for an average of 20 months, and none of them presented postoperative complications. The results evaluated by analogous scales are promising and invite us to establish this procedure as the gold standard. Conclusions: Strict evaluation is necessary for acetabular defects. The inclusion of medical IT makes it possible to study the need to use bank grafting and to manufacture custom-made multiporous trabecular titanium/tantalum implants, which is ideal for achieving osseointegration, added to the possibility of planning the direction and length of the screws to the remaining bone, according to its quality. The cementation of a dual mobility cup inside the customized implant reduces the risk of dislocation and overload of the latter, by eliminating metalmetal friction.

Palabras clave : Pelvic discontinuity; 3D cup; dual mobility; reconstructive acetabular revision; severe acetabular defects.

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