3d Modelling and Printing in Primary and Revision Arthroplasty

Загородний, Н. В.; Чрагян, Г. А.; Алексанян, О. А.; Kagramanov, S. V; Полевой, Е. В.

doi:10.32414/0869-8678-2018-2-21-29

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…Процесс создания и техника установки индивидуальных вертлужных компонентов ранее были тщательно описаны нами в предыдущей статье [9].…”

Section: описание медицинского вмешательстваunclassified

“…Наиболее частой причиной ревизионных операций является нестабильность вертлужного компонента [6][7][8]. Длительно протекающая нестабильность и неоднократные операции приводят к возникновению тяжёлых костных дефектов [9,10]. Ключевую роль при выборе тактики ревизионного эндопротезирования играет именно выраженность костного дефекта [11][12][13].…”

Section: Introductionunclassified

“…Однако состояние костной ткани, выраженность и геометрия дефекта требуют технических решений по адаптации ложа вертлужной впадины под серийные компоненты (чашки, аугменты) [20][21][22]. Поиски альтернативных вариантов реконструкций привели к внедрению в эндопротезирование аддитивных технологий, позволяющих с помощью 3D-моделирования создать и напечатать индивидуальный для каждого дефекта имплантат [9,[23][24][25][26]27]. Имплантаты данного типа обладают рядом особенностей [9]:…”

Section: Introductionunclassified

“…Поиски альтернативных вариантов реконструкций привели к внедрению в эндопротезирование аддитивных технологий, позволяющих с помощью 3D-моделирования создать и напечатать индивидуальный для каждого дефекта имплантат [9,[23][24][25][26]27]. Имплантаты данного типа обладают рядом особенностей [9]:…”

Section: Introductionunclassified

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Early results of revision acetabular endoprosthetics using individual designs

Aleksanyan

Chragyan

Kagramanov

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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BACKGROUND: 3D-printed implants are one of the options for acetabulum reconstruction. The popularity of this technique is increasing every year. AIM: To evaluate the early clinical, radiological and functional results of revision arthroplasty using individual acetabular components in patients with acetabulum bone defects. MATERIALS AND METHODS: Revision endoprosthetics was performed in 50 patients. There were 36 female and 14 male patients. The patients mean age was 60.413.4 (2389) years. According to the Paprosky classification, the defects in 1 case corresponded to type IIC, in 12 cases to type IIIA, in 37 cases to type IIIB, including 8 cases with violation of the acetabulum integrity. Hip joint function was assessed using the Harris Hip Score (HHS), pain severity using the Visual Analogue Scale (VAS), and social adjustment using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). RESULTS: Significant improvement was obtained on all assessment scales. The HHS score improved on average from 33.6 to 87.1 points, the VAS scale from 78.1 to 4.7 points, and the WOMAC from 75.8 to 11.6 points. There were 8 cases (21%) with complications in total. In one case with a violation of the acetabulum integrity we observed migration of the sciatic bone from the lower flange of the construct. CONCLUSION: Thus, the results of the acetabulum reconstruction using individually fabricated acetabular components are promising.

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Section: описание медицинского вмешательстваunclassified

Section: Introductionunclassified

See 2 more Smart Citations

Early results of revision acetabular endoprosthetics using individual designs

Aleksanyan

Chragyan

Kagramanov

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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Reconstruction of a hip socket using trabecular metal components

Zagorodniy

В²,

Alexanyan

et al. 2019

N.N. Priorov Journal of Traumatology and Orthopedics

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Introduction. Fixation of the acetabular component in patients with bone defects of the acetabulum is a difficult task due to the insufficient quantity and poor quality of the remaining bone tissue. During the last few years in our country in arthroplasty of the acetabulum with severe bone defects were actively used implants made of trabecular metal. Purpose of study: was to evaluate short-term clinical and radiological results of the usage of trabecular metal components in patients with bone defects in revision and primary hip replacement. Patients and methods. 59 surgeries were performed using components of trabecular metal, 53 of them were performed on the instability of the hip prosthesis, 2 - post-traumatic hip dysplasia, 2 - aseptic necrosis of the femoral head, 2 - high dislocation of the femoral head. Among the operated there were 37 women and 22 men, the average age was 58.2±19.9 years. According to the Paprosky classification, defects in 12 cases corresponded to type IIA, in 14 - type IIB, in 6 - type II, in 19 - type IIIA, in 7 - type IIIB. The structural features of these implants, made of tantalum in a carbon skeleton with uniform porosity, similar to the structure of bone tissue, provide an increased coefficient of friction, thereby contributing to the rapid growth of bone tissue in the implant structure. Results. The average follow-up period was 14 months. The average preoperative assessment of the hip joint by Harris Hip Score (HHS) was 43 points (from 14 to 86). After surgery, the average HHS improved to 88.7 (69 to 100). 1 patient had hemorrhagic discharge after surgery. On the 7th day an audit was performed. In 2 cases, paresis of the peroneal portion of the sciatic nerve developed after surgery. There were no cases of recurrent dislocations, deep infection, pulmonary embolism or death as a result of operations. Conclusion. Taking into account the mechanical properties, tantalum implants allow to achieve a stable primary fixation with the restoration of the center of rotation of the hip joint and eliminate the risks associated with the use of allografts. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

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A new method for adapting the acetabulum for installation of customized implants

Varfolomeev

2021

Science and Innovations in Medicine

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Aim to assess the accuracy and duration of acetabulum adaptation when using the developed method of installing the acetabular components of the hip joint endoprosthesis. Material and methods. A method and a special device for its implementation have been developed for adapting of the acetabulum with defects. An experimental study was conducted on 3D printed plastic models of pelvic bones of patients with acetabulum defects of type 2A-3B according to the Paprosky classification. In the main group, pelvic bones were treated using the developed method. The control group used Zimmer (USA) hip endoprosthesis kit cutters as well as standard surgical instruments. The accuracy of the pelvic bone treatment was evaluated by the volume of liquid silicone that was poured into the space between the endoprosthesis component and the pelvic bone. The duration of preparation of the acetabulum for cup implantation was assessed using a stopwatch. Results. The mean duration of pelvic bone preparation for cup implantation did not differ significantly between the groups (p = 0.7). The average volume of solidified silicone in the space between the cup and the pelvic bone model in the main group was significantly less than in the control group (p = 0.02). This indicates a high accuracy of the acetabulum adaptation. Acetabulum wall damage in control group occurred in 5 cases. Conclusion. The proposed method and the device for its implementation allow you to prepare the pelvic bone for implantation of a customized cup with high accuracy. Its application can simplify the complex revision operations and reduce their invasiveness.

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3d Modelling and Printing in Primary and Revision Arthroplasty

Cited by 3 publications

References 28 publications

Early results of revision acetabular endoprosthetics using individual designs

Early results of revision acetabular endoprosthetics using individual designs

Reconstruction of a hip socket using trabecular metal components

A new method for adapting the acetabulum for installation of customized implants

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