The triflange cup: Build it and they will wait

The custom triflange is designed from CT images of the pelvis which delineate the remaining acetabular and pelvic bone. The design of the triflange involves both the manufacturing engineer and surgeon to determine the most appropriate implant shape, screw fixation pattern, and cup location and orientation. A wide surgical exposure is needed with identification of the sciatic nerve. Proximal dissection of the abductors above the sciatic notch to position the iliac flange can result in denervation of the abductor mechanism. Although the risk of complications with this technique is relatively high, satisfactory restoration of hip function can be achieved in most cases. The use of a custom triflange is indicated for massive bone loss and discontinuity in which other reconstructive options are not considered suitable.