From Pre-op to Post-op.
Pre-operative situation
A 75-year old patient (1,58m height, 50kg weight) presented herself at the clinic with a left acetabular cup loosening after total hip replacement. The patient previously underwent 6 surgeries of the left hip. The implant in situ is a broken Müller shell with a large cranial defect, medial breakthrough and significant weakening of the ventral column. Various screws have been implanted, the flap of the support shell has overgrown bony laterally. LINK was asked to develop a customized partial pelvis replacement.
Design Planning
The patient-specific design of the required implant was planned by the customLINK engineers on the basis of the CT data. For this purpose, 3D models of the bone were created from the CT data by segmentation and the individual implant components were designed on the basis of this bone model.
The center of rotation is digitally planned with reference to the contralateral side. Main fixation of the implant is taken by a cementless iliac stem along the Linea Arcuata featuring TrabecuLink structure as well as cancellous and cortical screws.
For an optimal solution the geometry and fit of the implant components were evaluated using several cross-sectional views in the CT sections (1-6). Main fixation of the implant is taken by a cementless iliac stem along the Linea Arcuata featuring TrabecuLink structure as well as cancellous and cortical screws.
Implant
The implant is designed with an ilium flap intended for cortical screw fixation and a defect bridging ischium flap. Furthermore the defect is augmented by the geometry of the implant featuring TrabecuLink structure at the bone contact surfaces for promoted bone ingrowth. A cup from the standard Link portfolio can be cemented into the customized partial pelvis replacement.
Post-operative situation
The customized partial pelvis replacement was successfully implanted in combination with the Bimobile Dual Mobility System from the standard Link portfolio.
Do you have a challenge like this?
Please send us CT data of the defect situation taken in 2mm resolution and according to our CT protocol, along with information about the desired resection.
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Waldemar Link GmbH & Co. KG
Endoprostheses "Made in Germany"
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