# Surgical Management of Cystic Pelvic Hydatid Bone Disease Using Additively Manufactured Customized Implants for Salvage Reconstruction: A Report of Two Cases

## TL;DR

Two patients with severe pelvic hydatid disease were successfully treated using custom 3D-printed implants, restoring hip function and showing no infection recurrence.

## Contribution

Demonstrates the effectiveness of additive manufacturing for customized implants in complex pelvic hydatid disease cases.

## Key findings

- Custom tri-flanged implants restored hip functionality and anatomy in two patients with severe pelvic hydatid disease.
- Short-term monitoring showed successful implant integration and no infection recurrence.
- The two-step surgical approach with AM implants proved effective for salvage reconstruction.

## Abstract

The diagnosis and treatment of pelvic bone hydatidosis (BH) present substantial challenges for orthopedic surgeons, requiring collaboration with parasitologists, radiologists, pathologists, and engineers. Surgical treatment selection depends on factors such as the extent of bone loss, soft tissue management, previously applied therapies, and local colonization status.

This report details the advanced management of two young patients diagnosed late with severe cystic pelvic BH, an atypical presentation due to their geographic origin and age. Following extensive diagnostic assessments, including serology and 3D imaging, the patients underwent a two-step surgical intervention. The initial surgery involved extensive debridement and the placement of a poly-methyl-methacrylate spacer, followed by a second procedure utilizing a custom-made, tri-flanged implant for definitive pelvic reconstruction. The custom implant, designed via an electron beam melting process, successfully restored hip functionality and anatomy, as evidenced by improvements in functional scores and post-operative imaging. Short-term monitoring confirmed the integration of the implant and the absence of infection recurrence, demonstrating the approach's effectiveness.

These cases highlight the potential of using additive manufacturing (AM) to create patient-specific implants for managing complex hip cases and emphasize the necessity for early detection and a multidisciplinary approach in treatment planning.