What is Custom Implant Reconstruction?

Also known as: Custom-made implant surgery, patient-specific implant reconstruction, acetabular revision with custom implant, triflange implant, custom augment, segmental bone defect reconstruction, custom glenoid implant, patient-specific prosthesis

Some defects have no implant made for them. A hip revised for the third time with the columns gone, a glenoid eroded years after a hemiarthroplasty, a segment of radius or tibia lost to trauma or to a tumour resection: in each case the standard revision component is designed for bone that is no longer there. The options are to build something out of graft and hope it takes the load, or to design the implant around the anatomy that remains.

A custom implant reconstruction takes the second route. The CT is turned into a three-dimensional model of the defect, the reconstruction target is set, usually restoring the centre of rotation or the mechanical axis to where it should be, and an implant is designed against the residual bone surfaces, with fixation placed where there is still bone to hold it. It is manufactured in titanium alloy, with trabecular surfaces where bone ingrowth is wanted, and it arrives with the guides that position it.

In Cyprus this route runs through Tailor Surgery (Sabadell, Spain), for which OrganoGEN is the exclusive distributor. The manufacturer's documented cases include an acetabular revision for a Paprosky IIIB defect reconstructed with a custom triflange component, a custom augment at the acetabulum, a custom trabecular-titanium glenoid component nine years after hemiarthroplasty, and upper and lower limb reconstruction with a custom spanning plate and a custom augment alongside grafting. These are single manufacturer-reported cases, not a series.

Where the plan calls for graft alongside the custom parts, SmartBone® is also available through OrganoGEN, and standard fixation is available from Hofer Osteosynthesis.

Am I a candidate?

Good candidates

• Acetabular revision with severe bone loss, including pelvic discontinuity, where a stock revision shell has inadequate support
• Glenoid bone loss or erosion after failed arthroplasty, unsuitable for a standard baseplate
• Segmental bone defects after trauma, infection or tumour resection
• Failed previous reconstruction where the remaining anatomy no longer matches any catalogue implant
• A patient fit for a long complex reconstruction and able to follow a protected rehabilitation programme

Patients in whom another option may be preferred

• Active infection, until it is eradicated and confirmed
• Defects a stock revision implant would address just as well, where a custom device adds cost and lead time without benefit
• Cases that cannot wait the planning and manufacturing time
• A patient unfit for the length and complexity of the reconstruction

GESY coverage & out-of-pocket cost

A custom-made implant has no standard GESY code, because it exists only for one patient. OrganoGEN prepares and submits an individual reimbursement application for each case, and approval is secured before manufacturing begins: once production of a custom device starts it cannot be cancelled. The surgical episode itself follows the usual GESY pathway for the operating surgeon and hospital.

For self-pay and international patients the complete system is quoted up front at a fixed price for the case. Surgeons can send a case for a costed proposal, and patients can request a quote.

Devices used in this procedure

Tailor Surgery Patient-Specific SystemOrthopaedics & Trauma · Patient-Specific Planning, Guides and Implantschevron_right

SmartBone® Synthetic Bone GraftBone Reconstruction · Synthetic Graftchevron_right

Where to have Custom Implant Reconstruction in Cyprus

OrganoGEN supplies GESY-contracted hospitals across the island. Contact us for the current list of participating surgeons in: