Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomes

Abstract Background Severe acetabular bone defects (Paprosky type III) pose significant challenges for reconstruction and stable implant fixation. This study aimed to analyze the biomechanical properties and clinical safety of personalized 3D-printed porous titanium alloy reinforcement augments and...

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Main Authors: Tengbin Shi, Wenming Zhang, Xinyu Fang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:3D Printing in Medicine
Subjects:
Online Access:https://doi.org/10.1186/s41205-025-00293-8
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author Tengbin Shi
Wenming Zhang
Xinyu Fang
author_facet Tengbin Shi
Wenming Zhang
Xinyu Fang
author_sort Tengbin Shi
collection DOAJ
description Abstract Background Severe acetabular bone defects (Paprosky type III) pose significant challenges for reconstruction and stable implant fixation. This study aimed to analyze the biomechanical properties and clinical safety of personalized 3D-printed porous titanium alloy reinforcement augments and evaluate their therapeutic efficacy in reconstructing these complex defects. Methods We reviewed three cases of Paprosky type III acetabular defects reconstructed using personalized 3D-printed porous titanium alloy augments. Finite element analysis (FEA) simulated the defects, utilizing a commercial augment as a control. Stress distribution within the augments, fixation screws, acetabular cups, and surrounding bone was analyzed under simulated single-leg standing (1 × body weight), walking (4 × BW), and jogging (6 × BW) loading conditions, with comparisons made to the control. Results Under all loading conditions, the peak stresses observed on the augment screws and acetabular cups in all three cases were lower than the buckling strength of titanium alloy and were consistently lower than those recorded in the control group. This indicates that the personalized augments provided stable support for acetabular cup fixation, aiding in the restoration of the hip rotation center and lower limb length. Conclusions Personalized 3D-printed porous titanium alloy augments demonstrate favorable biomechanical safety and clinical efficacy based on FEA and initial case review. For severe acetabular bone defects, these custom augments offer good initial stability, promoting bone integration for long-term fixation, and potentially reducing risks associated with cup loosening, dislocation, and periprosthetic fracture.
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spelling doaj-art-b9e4d4a7585c40d1bdbfe7925013eda42025-08-20T03:42:40ZengBMC3D Printing in Medicine2365-62712025-07-0111111110.1186/s41205-025-00293-8Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomesTengbin Shi0Wenming Zhang1Xinyu Fang2Department of Orthopedic Surgery, Fujian Medical University Union HospitalDepartment of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical UniversityDepartment of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical UniversityAbstract Background Severe acetabular bone defects (Paprosky type III) pose significant challenges for reconstruction and stable implant fixation. This study aimed to analyze the biomechanical properties and clinical safety of personalized 3D-printed porous titanium alloy reinforcement augments and evaluate their therapeutic efficacy in reconstructing these complex defects. Methods We reviewed three cases of Paprosky type III acetabular defects reconstructed using personalized 3D-printed porous titanium alloy augments. Finite element analysis (FEA) simulated the defects, utilizing a commercial augment as a control. Stress distribution within the augments, fixation screws, acetabular cups, and surrounding bone was analyzed under simulated single-leg standing (1 × body weight), walking (4 × BW), and jogging (6 × BW) loading conditions, with comparisons made to the control. Results Under all loading conditions, the peak stresses observed on the augment screws and acetabular cups in all three cases were lower than the buckling strength of titanium alloy and were consistently lower than those recorded in the control group. This indicates that the personalized augments provided stable support for acetabular cup fixation, aiding in the restoration of the hip rotation center and lower limb length. Conclusions Personalized 3D-printed porous titanium alloy augments demonstrate favorable biomechanical safety and clinical efficacy based on FEA and initial case review. For severe acetabular bone defects, these custom augments offer good initial stability, promoting bone integration for long-term fixation, and potentially reducing risks associated with cup loosening, dislocation, and periprosthetic fracture.https://doi.org/10.1186/s41205-025-00293-8Acetabular reconstruction3D printed augmentFinite element analysisClinical outcomePersonalized implant
spellingShingle Tengbin Shi
Wenming Zhang
Xinyu Fang
Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomes
3D Printing in Medicine
Acetabular reconstruction
3D printed augment
Finite element analysis
Clinical outcome
Personalized implant
title Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomes
title_full Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomes
title_fullStr Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomes
title_full_unstemmed Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomes
title_short Custom 3D-printed porous titanium augments for Paprosky type III acetabular defects: a case series combining biomechanical rationale with early clinical outcomes
title_sort custom 3d printed porous titanium augments for paprosky type iii acetabular defects a case series combining biomechanical rationale with early clinical outcomes
topic Acetabular reconstruction
3D printed augment
Finite element analysis
Clinical outcome
Personalized implant
url https://doi.org/10.1186/s41205-025-00293-8
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