The treatment of extensive bone loss and massive acetabular defects is a challenging procedure, especially the concomitant pelvic discontinuity (PD) can be compounded by several challenges and pitfalls. The appropriate treatment strategy is to restore a stable continuity between the ischium and the ilium and to reconstruct the anatomical hip center. Antiprotrusio cages, metal augments, reconstruction cages with screw fixation, structural allograft with plating, jumbo cups, oblong cups and custom-made triflange acetabular components have been reported as possible treatment options. Nevertheless, the survivorship following acetabular revision with extensive bone loss is still unsatisfactory. The innovation of three-dimensional printing (3DP) has become already revolutionary in engineering and product design. Nowadays, the technology is becoming part of surgical practice and suitable for the production of precise and bespoke implants. The technique of a 3D-printed custom acetabular component in the management of extensive acetabular defect is presented

The treatment of extensive bone loss and massive acetabular defects is a challenging procedure, especially in cases with concomitant pelvic discontinuity (PD). Pelvic discontinuity describes the separation of the ilium proximally from the ischio-pubic region distally. The appropriate treatment strategy is to restore a stable continuity between the ischium and the ilium to reconstruct the anatomical hip center. Several treatment options such as antiprotrusio cages, metal augments, reconstruction cages with screw fixation, structural allograft with plating, jumbo cups, oblong cups and custom-made triflange acetabular components have been described as possible treatment options. Cage and/or ring constructs or acetabular allograft are commonly used techniques with unsatisfactory results and high failure rates. More favorable results have been presented with custom triflange acetabular components (CTAC), although the results are still unsatisfactory. Three-dimensional printing technology (3DP) has already become part of the surgical practice. In this context, preliminary clinical and radiological results using a 3D-printed custom acetabular component in the management of extensive acetabular defects are presented. The overall complication rate was 33.3 %. In one out of 15 patients (6.6 %), implant-associated complication occurred revealing an overall implant-associated survival rate of 93.3%. The 3D-printed custom acetabular component suggests a promising future, although the manufacturing process has high costs and the complication rate is still high