How to Develope a Novel 3D Printed Integral Customized Anatomical Acetabular Prosthesis in Hip Arthroplasty for Crowe Type II and III Developmental Dysplasia of the Hip?

BackgroundThe acetabular pathomorphology in patients with Crowe type II and III developmental dysplasia of the hip(DDH)often present complicated changes, which bring challenges to the anatomical reconstruction of acetabulum in total hip arthroplasty (THA). The objective of this study was to develope a novel 3D printed integral customized acetabular prosthesis, which provides a promising way to reconstruct the acetabulum with higher accuracy and efficiency by digital softwares, compared with previous 3D printing model method. Methods15 patients (18 hips) with end-stage hip osteoarthritis due to Crowe type II/III DDH who underwent primary cementless THA from January 2015 to November 2021 were included. The 15 patients consisted of 3 men (3 hips) and 12 women (15 hips) with an average age of 53.89 {+/-} 8.48 years (range from 32 to 69 years). The novel 3D printed integral customized acetabular prosthesis was designed by the model method and software method respectively. The indicators of the cup size, the volume and superficial area of bone defect, the inclination and anteversion of acetabular cup, the horizontal and vertical distance of hip center and working time were compared between two methods. ResultsThere were statistically significant difference between the software group and model group on the volume and superficial area of bone defect as well as working time (t = 2.397, 2.707,138.509, P < 0.05). The mean anteversion and inclination of acetabular cup in the software group and model group were(15.17{+/-}0.52){degrees},(40.24{+/-}0.58){degrees}and (33.79 {+/-}13.43){degrees}, (30.50 {+/-}11.03){degrees}respectively, the difference was statistically significant (t = 5.859, 3.767, P < 0.05).There were no statistically significant difference between the software group and model group on cup size, the horizontal and vertical distance of hip center(t =1.458,0.114, 1.712, P > 0.05) ConclusionsThe application of digital softwares could design and develope the novel 3D printed integral customized anatomical acetabular prosthesis in THA for {square}Crowe type II and III DDH with high accuracy and efficiency.