Is Cranial Reconstruction With a Hard-Tissue Replacement Patient-Matched Implant as Safe as Previously Reported? A 3-Year Experience and Review of the Literature

PurposeThis study aimed to verify the low complication rates (0% to 11%) previously reported in cranial reconstruction using hard-tissue replacement patient-matched implant (HTR-PMI).Patients and MethodsA 3-year multidisciplinary experience involving 21 patients undergoing HTR-PMI reconstruction of large cranial defects was reviewed. Complications were defined as implant exposure, implant infection, or soft-tissue infection.ResultsA statistically higher rate of complications was observed, compared with previous series (P = .043). We also determined whether previous bone infection, a history of diabetes, or smoking were risk factors for the development of complications. Diabetes, smoking, and pre-existing bone/implant infections were not significant risk factors for HTR-PMI failure. The higher rate of complications can be partially attributed to a diverse and complicated patient population, with multiple comorbid conditions and various indications for HTR-PMI reconstruction. In particular, decompressive craniectomies in trauma patients can be risky indications for the use of HTR-PMI.ConclusionLarger studies are suggested to verify our findings.