{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:53:55Z","timestamp":1793332435752,"version":"4.5.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Treatment of massive acetabular defects, both with and without pelvic discontinuity, is challenging. The implants utilized in the surgical procedure need to be stable and integrate with poor host bone stock. In the present study, we describe our experience addressing this challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We identified all patients who underwent surgical implantation of a custom 3D-printed triflange prosthesis with dual-mobility bearings for the treatment of Paprosky 3B acetabular defects between 2014 and 2020. Operative, functional, and radiographic outcomes were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 19 patients were identified, including 11 women. The mean age was 77 years (range, 53 to 91 years), and 8 patients (42%) had proven or likely pelvic discontinuity. The mean follow-up was 53 months (range, 17 to 88 months; mode, 57 months). The cumulative implant survivorship was 100%. Two patients suffered notable sciatic nerve palsy, with 1 case being recurrent. There were no dislocations or fractures. The mean Oxford Hip Score improved significantly, from a mean of 8.6 (range, 0 to 22) preoperatively to 35 (range, 10 to 48) postoperatively (p &lt; 0.0001). Radiographically, there was excellent correlation between implant position and the preoperative plan (p &gt; 0.05). There were no cases of implant loosening or migration, which suggests that stabilization was achieved even among cases with pelvic discontinuity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These early results suggest that the use of a custom 3D-printed triflange implant has potential advantages over traditional constructs in the treatment of massive acetabular defects, with and without pelvic discontinuity. Excellent implant survivorship and functional improvement were demonstrated in this challenging patient cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.21.00057","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T14:07:27Z","timestamp":1634825247000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Custom 3D-Printed Triflange Implants for Treatment of Severe Acetabular Defects, with and without Pelvic Discontinuity"],"prefix":"10.2106","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6050-6925","authenticated-orcid":false,"given":"Vitali","family":"Goriainov","sequence":"first","affiliation":[{"name":"Bone and Joint Research Group, Centre for Human Development, Stem Cells & Regeneration, Institute of Developmental Sciences, University of Southampton, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3026-4264","authenticated-orcid":false,"given":"Leonard J.","family":"King","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5995-6726","authenticated-orcid":false,"given":"Richard O.C.","family":"Oreffo","sequence":"additional","affiliation":[{"name":"Bone and Joint Research Group, Centre for Human Development, Stem Cells & Regeneration, Institute of Developmental Sciences, University of Southampton, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas G.","family":"Dunlop","sequence":"additional","affiliation":[{"name":"Bone and Joint Research Group, Centre for Human Development, Stem Cells & Regeneration, Institute of Developmental Sciences, University of Southampton, Southampton, United Kingdom"},{"name":"Department of Trauma and Orthopaedics, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10]]},"reference":[{"issue":"1","key":"R2-20240801","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/0883-5403(94)90135-X","article-title":"Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation","volume":"9","author":"Paprosky","year":"1994","journal-title":"J Arthroplasty"},{"issue":"12","key":"R3-20240801","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.2106\/00004623-199912000-00006","article-title":"Pelvic discontinuity in revision total hip arthroplasty","volume":"81","author":"Berry","year":"1999","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"R4-20240801","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1302\/0301-620X.91B7.22181","article-title":"Acetabular revision using an anti-protrusion (ilio-ischial) cage and trabecular metal acetabular component for severe acetabular bone loss associated with pelvic discontinuity","volume":"91","author":"Kosashvili","year":"2009","journal-title":"J Bone Joint Surg Br"},{"issue":"12","key":"R5-20240801","doi-asserted-by":"crossref","first-page":"3295","DOI":"10.1007\/s11999-010-1591-2","article-title":"Long-term results for minor column allografts in revision hip arthroplasty","volume":"468","author":"Lee","year":"2010","journal-title":"Clin Orthop Relat Res"},{"issue":"5","key":"R6-20240801","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1007\/s00264-016-3312-2","article-title":"Use of porous tantalum components in Paprosky two and three acetabular revision. A minimum five-year follow-up of fifty one hips","volume":"41","author":"Flecher","year":"2017","journal-title":"Int Orthop"},{"issue":"11","key":"R7-20240801","doi-asserted-by":"crossref","first-page":"3156","DOI":"10.1007\/s11999-012-2514-1","article-title":"Acetabular distraction: an alternative for severe defects with chronic pelvic discontinuity?","volume":"470","author":"Sporer","year":"2012","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"R8-20240801","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.arth.2012.11.010","article-title":"Use of jumbo cups for revision of acetabulae with large bony defects","volume":"29","author":"Gustke","year":"2014","journal-title":"J Arthroplasty"},{"issue":"2","key":"R9-20240801","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1007\/s11999-015-4210-4","article-title":"Promising Mid-term Results With a Cup-cage Construct for Large Acetabular Defects and Pelvic Discontinuity","volume":"474","author":"Amenabar","year":"2016","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"R10-20240801","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s11999-011-2170-x","article-title":"Tantalum augments for Paprosky IIIA defects remain stable at midterm followup","volume":"470","author":"Del Gaizo","year":"2012","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"R11-20240801","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1302\/0301-620X.98B.36354","article-title":"The custom triflange cup: build it and they will come","volume":"98-B","author":"Goodman","year":"2016","journal-title":"Bone Joint J"},{"issue":"11","key":"R12-20240801","doi-asserted-by":"crossref","first-page":"E2682","DOI":"10.3390\/polym12112682","article-title":"3D Printing for Hip Implant Applications: A Review","volume":"12","author":"Okolie","year":"2020","journal-title":"Polymers 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Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.21.00057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:37:55Z","timestamp":1787751475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.21.00057"}},"subtitle":["Early Results of Our First 19 Consecutive Cases"],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.oa.21.00057","relation":{},"ISSN":["2472-7245"],"issn-type":[{"value":"2472-7245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}