3D-printed models for periacetabular osteotomy surgical planning

Abstract

The purpose of this study was to determine the feasibility and clinical benefits of using 3D-printed hemipelvis models for periacetabular osteotomy preoperative planning in the treatment of hip dysplasia. This retrospective study included 28 consecutive cases in 26 patients, with two bilateral cases, who underwent periacetabular osteotomy between January 2017 and February 2020 and had routine radiographs, CT and MR imaging. Of these, 14 cases [mean patient age 30.7 (SD 8.4) years, 11 female] had routine preoperative imaging, and 14 cases [mean patient age 28.0 (SD 8.7) years, 13 female] had routine preoperative imaging and creation of a full-scale 3D-printed hemipelvis model from the CT data. The expected surgical cuts were performed on the 3D-printed models. All patients underwent Bernese periacetabular osteotomy. Operative times, including time to achieve proper acetabular position and total periacetabular osteotomy time, fluoroscopy radiation dose and estimated total blood loss were compiled. ANOVA compared outcome variables between the two patient groups, controlling for possible confounders. On average, patients who had additional preoperative planning using the 3D-printed model had a 5.5-min reduction in time to achieve proper acetabular position and a 14.5-min reduction in total periacetabular osteotomy time; however, these changes were not statistically significant (P = 0.526 and 0.151, respectively). No significant difference was identified in fluoroscopy radiation dose or total blood loss. Detailed surgical planning for periacetabular osteotomy using 3D-printed models is feasible using widely available and affordable technology and shows promise to improve surgical efficiency.

Application of 3D-printed osteotomy guides in periacetabular osteotomy: A short-term clinical study

“…20 Markhardt et al observed that the reduction of operation time, including the average time to reach the appropriate acetabular position and the average total PAO time, improved operation efficiency. 21 In this study, the same results were found. Meanwhile, the use of PSI has greatly simplified the positioning of special osteotomy angles and positions during acetabular osteotomy.…”

The Scientific Evolution of Periacetabular Osteotomy: A Global Review

“…A glimpse at the future would reflect major advances related to individual planning, surgical training, and precise surgical conduction. This will include 3D modeling and printing as well as individualized cutting guides that aid the planning and conduction of the procedure [ 43 ].…”

A systematic approach to CT evaluation of non-arthritic hip pain

“…These approaches allow one to measure radiographic parameters in real-time before and after virtual surgical interventions, including osteotomies and osteoplasties. The introduction of 3D printing of CT-derived anatomy allows for hands-on understanding of the bony morphology which also aids in surgical decision-making ( 53 ). While the details of these advanced techniques are beyond the scope of this article, their prospect is certainly noteworthy.…”