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General Orthopaedics

THE TRIFLANGE CUP: BUILD IT AND THEY WILL WAIT

Current Concepts in Joint Replacement (CCJR) Spring 2016



Abstract

Acetabular defects often result from osteolysis with or without component loosening. The goals of acetabular reconstruction in the face of significant rim or column deficiencies are to create a stable acetabular construct, which will facilitate acetabular component biologic fixation and long-term stability. Four reconstructive techniques have emerged to treat these defects: 1) Large allografts, 2) Cup / Cage constructs, 3) Metallic augments and uncemented hemispherical cups, and 4) Triflange custom implants.

While all of these techniques have demonstrated success, we have elected to pursue triflange implants to improve fixation on host bone, allow modular liner options, facilitate enhanced fixation surfaces, match patient complex geometries, opportunity to utilise locking screws, and possibly reduce surgical operative time. Furthermore, screw paths and lengths can be planned pre-operatively along with custom pelvic model generation which makes surgical exposure and reconstructive more understandable.

Multiple studies have shown excellent survivorship in series of the most challenging acetabular reconstructions.