Title
Technical Evaluation of Trabecular Metal Augments and Custom Implants in Severe Acetabular Bone Deficiencies
Author
Barends, Jessica (TU Delft Mechanical, Maritime and Materials Engineering; Leiden University Medical Center)
Contributor
Kaptein, Bart (mentor)
Nelissen, Rob (mentor)
Broekhuis, Demien (mentor)
Corten, Eveline (graduation committee)
Harlaar, J. (graduation committee) 
Degree granting institution
Delft University of Technology
Leiden University Medical Center
Programme
Technical Medicine
Date
2022-10-31
Abstract
Introduction: Revision total hip arthroplasty (THA) can be challenging in patients with severe acetabular bone defects and there is no consensus on the preferred reconstruction technique in this population. The aim of this study is to determine the biomechanical differences between Trabecular Metal Acetabular Revision System (TMARS) and Custom Triflange Acetabular Component (CTAC), in patients with Paprosky grade IIIB acetabular bone defects.
Methods: A retrospective study with patients undergoing revision THA surgery TMARS was conducted. For all these patients a virtual CTAC was designed. With this, the TMARS reconstruction could be compared with the virtual CTAC. Assessments of both implants included cortical and cancellous bone contact, center of rotation (COR), inclination, anteversion, and reamed bone volume.
Results: The mean bone contact was 5760 mm2 vs 5447 mm2 for TMARS and CTAC respectively. The TMARS showed significantly more cancellous bone contact than the CTAC (4966 mm2 vs 2887 mm2) and less cortical contact (795 mm2 vs 2560 mm2). The TMARS COR was significantly deviated in the medial-lateral direction compared to the CTAC, with a mean difference of 7.4 mm in lateral direction. TMARS showed a significantly greater reamed bone volume with a mean of 15997 mm3 for TMARS and 2292 mm3 for CTAC.
Conclusion: A semi-automatic method was designed for the determination of the biomechanical differences between TMARS and CTAC reconstructions. TMARS showed significant more cancellous bone contact, but also significant greater reamed bone volume with respect to CTAC. Furthermore, the TMARS COR was localized significantly more lateral compared to CTAC.
Subject
revision total hip arthroplasty
trabecular metal
custom-design implants
severe bone defect
pelvic discontinuity
To reference this document use:
http://resolver.tudelft.nl/uuid:744f8b08-a4ea-496c-b444-8d9469496a4f
Embargo date
2027-10-31
Part of collection
Student theses
Document type
master thesis
Rights
© 2022 Jessica Barends