Custom triflange acetabular components for large acetabular defect reconstruction in revision total hip arthroplasty: a systematic review and meta-analysis on 1218 patients

& BULL; Purpose: This is a systematic review and meta(regression) analysis to assess the performance of custom triflange acetabular components (CTAC) in total hip arthroplasty (THA) revision surgery. Implant-related complications, failure rate, functional outcomes and implant and surgical technique-related predictors for outcome were assessed.& BULL; Methods: This systematic review was performed according to PRISMA guidelines and COCHRANE Library and Emcare were searched. Studies on Paprosky type 3A and 3B or AAOS type 3 and 4 acetabular defects with a minimum follow-up of 12 months and cohorts > 10 patients were included.& BULL; Results: Thirty-three studies were eligible for inclusion (n = 1235 hips, 1218 patients). The methodological quality of the studies was moderate (AQUILA: 7.4/11 points). Considerable heterogeneity was observed in terms of complications, re-operations and implant failure reporting. The total incidence of implant-related complications was 24%. The incidence of re-operation for any reason was 15%, and the implant failure rate was 12% at a mean of 46.9 months and the post-operative Harris Hip Score improved by a mean of 40 points. Several predictors for outcome were found, such as implant generation, follow-up length and study start date.& BULL; Conclusions: The use of CTAC in revision THA has satisfactory complication and implant failure rates. The CTAC technique improves post-operative clinical outcomes and the metaregression analysis showed that there is a clear association between improvements in the CTAC performance and the evolvement of this technique over time.

Automated summary

This study systematically reviewed and meta-analyzed the performance of custom triflange acetabular components (CTAC) in revision total hip arthroplasty (THA) surgery. The results showed satisfactory complication and implant failure rates, as well as improved post-operative clinical outcomes with the use of CTAC.