Conclusions

This case illustrates that combined custom-made acetabular and femoral components can achieve durable anatomical reconstruction and meaningful functional recovery in a primary THA setting where severe, concurrent acetabular and femoral bone deficiency renders standard implants unusable. Despite the occurrence of an early postoperative dislocation, the patient achieved restoration of the center of rotation, correction of limb-length discrepancy, and a marked improvement in HHS with stable, well-fixed implants at two-year follow-up. These findings suggest that patient-specific implants are a viable strategy for patients with altered bone morphology who have been refused conventional surgery, though careful attention to soft-tissue balance, abductor competence, and spinopelvic alignment is warranted to mitigate the elevated dislocation risk inherent to this population. Further studies with larger cohorts and longer follow-up are needed to confirm the long-term reliability of this dual-custom-implant approach.