Outcomes of reconstruction of complex pelvic discontinuities treated with either distraction technique or 3D printed custom implants

A Assaf, SH Chen, G Stranks, T Evans, J Griffiths

Hampshire Hospitals Foundation Trust

Acute and chronic pelvic discontinuities are complex surgical entities, with a reported high failure rate. We present the survivorship of reconstruction of pelvic discontinuities, using either distraction techniques, or 3D printed custom implants

In this single surgeon, single-centre retrospective cohort study, all discontinuity cases from September 2016-March 2023 were included. Cases were discussed at the local MDT (instigated and chaired by the senior author) in the presence of radiology, microbiology and orthopaedic consultants. Primary outcome measure was re-revision rate, with secondary outcomes being re-operation for any other cause, as well as radiological assessment.

18 patients were included. 16 cases were chronic, and 2 cases were acute. 8 cases were reconstructed with a 3D printed Custom triflange prosthesis, and 10 cases were reconstructed with a distraction technique, two of which were also column plated. The average distraction was 11mm. Average follow-up of both groups is 43 months, out to 7 years. Average follow ups were 53 months and 30 months for distraction and 3D printed groups, respectively. Overall survivorship of both groups is 100% out to 7 years, with no reinterventions for any cause. There were no radiological signs of loosening in follow-up XRs. There was one case of a transient and partial sciatic nerve palsy due to mobilisation of the nerve off pelvic callus. There was one case of a stitch abscess which resolved with oral antibiotics.

We present good clinical and radiological results with both distraction technique and 3D printed reconstruction of complex pelvic discontinuities.