Three-Dimensional Printed Patient-Specific Implants in Complex Acetabular Reconstruction

Abstract

Background: Massive acetabular bone loss from aseptic loosening, pelvic discontinuity, or peri-acetabular tumour resection
remains one of the most demanding problems in hip surgery, and conventional jumbo cups, cup-cage constructs, and structural
allografts have inconsistent fixation in the most severe defects. Objective: To synthesise evidence on three-dimensional (3D) printed patient-specific acetabular implants, their design-and-manufacturing workflow, and outcomes relative to conventional reconstruction.
Methods: Narrative review of clinical series, systematic reviews, and biomechanical studies of additively manufactured triflange,
monoblock, and hemipelvic implants. Findings: Custom triflange and porous monoblock implants achieve implant survivorship of 90-100% at intermediate follow-up with radiographic osseointegration exceeding 90%, comparing favourably with jumbo cups (95.0%) and trabecular titanium revision cups (92.5%). Conclusions: Patient-specific 3D-printed implants provide reliable fixation for Paprosky III defects, pelvic discontinuity, and tumour resection where conventional options fail, though cost, lead time, and long-term data remain limiting factors.