Acetabular reconstruction with a custom-made triflange acetabular component through direct anterior approach – A case report

Abstract: Complex acetabular reconstruction sometimes requires the use of a custom-made triflange acetabular component (CTAC). In this article we describe the surgical technique to achieve its implantation through the direct anterior approach (DAA). Meanwhile we report on our first aMace® CTAC placement in revision total hip arthroplasty through the DAA. Most procedures concerning the implantation of a CTAC are performed through the posterolateral approach to obtain adequate exposure. However, literature reports a high overall dislocation rate of 14% using this approach for revision hip arthroplasty. Because of the documented lower dislocation rate and a faster early rehabilitation of procedures performed through DAA, we considered to implant this vast acetabular reconstruction component through the same approach we use for our primary and standard revision cases. In collaboration with the engineers, the design and the screw direction were adapted to the DAA. We used a standard DAA with longitudinal incision and had no difficulty to successfully implant the CTAC in the desired implant position.