A systematic review of custom 3D-printed acetabular components in revision arthroplasty for the management of extensive acetabular defects.

Abstract

<h4>Purpose</h4>Multiple papers have been published focusing on the outcomes of custom 3D-printed acetabular components for revision arthroplasty in the management of extensive acetabular defects. However to our knowledge this is the first systematic review on the topic; we have reviewed outcomes and compared to the different methods of acetabular reconstruction. Our primary objective was to ascertain component survivorship and follow-up durations of these components within literature. Secondary objectives were to review their clinical outcomes and the limitations of the published studies.<h4>Methods</h4>5 databases were interrogated for publications from January 1st^, 2005 to June 1st^, 2022. A search strategy was devised using medical subject headings (MeSH) in line with guidelines from Preferred Reporting Items for Systematic Reviews (PRISMA) and the review was registered with the international prospective register of systematic reviews (PROSPERO).<h4>Results</h4>The search yielded 183 articles following elimination of duplicates. Then the application of the inclusion and exclusion criteria a total of 16 articles were finally included. A total of 283 hips were included in the analysis. The mean age was 65 (range 22-90 in studies that reported age range). The average follow-up was 22.8 months, with mean follow-up ranging from 12 to 65 months. At an average follow-up of 22.8 months the acetabular component survivorship rate was 97.7 %. The mean complication rate was 16.5 %, the re-operation rate was 5.4 %.<h4>Conclusion</h4>Our study presents to our knowledge the first systematic review of custom 3DAC in the setting of extensive acetabular defects. These components appear to offer an efficacious treatment modality in this complex setting, early results suggest both low failure rates and positive clinical outcome data. This reconstructive option allows the surgeon to maximise primary stability whilst minimising further bone loss and attempt to restore hip biomechanics in a patient cohort who often have had multiple previous revisions.