Современные технологии лечения тяжелых костных дефектов в области вертлужной впадины: какие проблемы решают индивидуальные имплантаты?

Individual acetabular implants are the defect-specific implants for revision hip arthroplasty. They recover the hip rotation center and secure the primary fixation in gross acetabular defects. Through a process of three-dimensional acetabular defect modelling and implant prototyping it becomes possible to reconstruct the acetabulum in some situations when other options are not applicable. Objective – to define the place, the role and future perspectives of individual acetabular implants in revision hip arthroplasty. Materials and methods. The published literature was analyzed for evaluation of necessity, indications, presurgical planning, designing and manufacture of individual acetabular implants. This article highlights the issues of surgical technique, current evidence of clinical and economic efficiency of individual acetabular implants. Results. Individual acetabular implants allows to reconstruct the acetabulum when other methods are inapplicable. The clinical results of their using are comparable with the known methods. The obstacles for their wide using are high cost and long manufacturing time. Conclusion. The basic conditions for a good clinical result are a possibility of stable fixation, biological osteointegration and restoration of favorable biomechanical parameters. The indications for individual acetabular implants should be clarified for more effective using. Some unsolved questions concern the definition of minimal sufficient contact, admissible shift in rotation center and improvement in techniques of bone tissue reconstruction.