Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13388-13395
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13388
Application of 3D-printed prosthesis in revision surgery with large inflammatory pseudotumour and extensive bone defect: A case report
Hong-Ping Wang, Ming-You Wang, Yu-Ping Lan, Zhuo-Dong Tang, Qi-Feng Tao, Chun-Yu Chen
Hong-Ping Wang, Yu-Ping Lan, Zhuo-Dong Tang, Qi-Feng Tao, Chun-Yu Chen, Department of Orthopaedics, Panzhihua Municipal Central Hospital, Panzhihua 617000, Sichuan Province, China
Ming-You Wang, Department of Clinical Medicine, Dali University, Dali 671000, Yunnan Province, China
Author contributions: Wang HP and Wang MY participated in the perioperative management, surgical process, and postoperative follow-up and wrote the main manuscript; Lan YP was in charge of the whole preoperative planning, operation scheme design and operation process and helped draft the manuscript and revise the article; Tao QF, Tang ZD and Chen CY were in charge of the follow-up of the patients and the collection and collation of the patients' pictures; All authors read and approved the final draft.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Ping Lan, BMed, Chief Physician, Doctor, Department of Orthopaedics, Panzhihua Municipal Central Hospital, No. 34 Yikang Street, Central Panzhihua Avenue, Panzhihua 617000, Sichuan Province, China. lanyuping@sina.com
Received: September 4, 2022
Peer-review started: September 4, 2022
First decision: October 12, 2022
Revised: November 5, 2022
Accepted: December 8, 2022
Article in press: December 8, 2022
Published online: December 26, 2022
Processing time: 113 Days and 3.5 Hours
Abstract
BACKGROUND

Hip revision surgery is the final treatment option for the failure of artificial hip joints, but it is more difficult than the initial operation. For patients with hip joint loosening around the prosthesis combined with large inflammatory pseudotumours and large segment bone defects, hip revision is even more difficult, and clinical reports are rare.

CASE SUMMARY

Male, 59 years old. The patient underwent left hip replacement 35 years ago and was now admitted to hospital due to massive masses in the left thigh, shortening of the left lower extremity, and pain and lameness of the left hip joint. X-ray, computed tomography and magnetic resonance imaging revealed prosthesis loosening, left acetabular bone defect (Parprosky IIIB type), and a bone defect of the left proximal femur (Parprosky IIIA type). Inflammatory pseudotumours were seen in the left hip and left thigh. Hip revision surgery was performed using a 3D-printed custom acetabular prosthesis was used for hip revision surgery, which was produced by Arcam Electron Beam Melting system with Electron Beam Melting technology. The operation was successful, and the patient was followed up regularly after the operation. The custom-made acetabular prosthesis was well matched, the inflammatory pseudotumour was completely removed, the postoperative hip prosthesis was stable, and the old greater trochanter fracture was well reduced and fixed. The patient was partially weight-bearing with crutches 3 mo after the operation and walked with full weight-bearing after 6 mo. The hip prosthesis was stable, and there was no recurrence of inflammatory pseudotumours at the last follow-up. The Visual Analogue Scale was 3, and the Harris hip score was 90.

CONCLUSION

The use of 3D-printed personalized custom prostheses for complex hip revision surgery has satisfactory surgical results and has great clinical application value.

Keywords: 3D printing, Inflammatory pseudotumour, Electron Beam Melting technology, Hip revision, Bone defect, Case report

Core Tip: We report a case of complex hip joint loosening around a prosthesis combined with a large inflammatory pseudotumor, extensive bone defect and an old fracture of the greater trochanter. A 3D-printed personalized prosthesis for artificial hip revision can be effectively installed. Preoperative planning and successful completion of complex hip revision surgery yielded good results.