Comparisons of Preoperative Three-Dimensional Planning and Surgical Reconstruction in Primary Cementless Total Hip Arthroplasty

Hassani, Hassen; Cherix, Stéphane; Ek, Eugene T.; Rüdiger, Hannes A.

doi:10.1016/j.arth.2013.12.033

Cited by 78 publications

(60 citation statements)

References 21 publications

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“…The 3D planning-guided THA showed a high accuracy, comparing well with the previously reported studies about the 3D planning methodology using the Hip-Plan software [11][12][13]. Furthermore, contrary to navigation or fluoroscopic guidance techniques [17], 3D planning uses only local anatomic landmarks and can be used as easily for all surgical approaches and regardless of the patient's position.…”

Section: Discussionsupporting

confidence: 64%

“…However, the conventional two-dimensional (2D) templating has a relatively low accuracy despite a correct image calibration [10,11]. With respect to the components size and position, an excellent accuracy was reported with a novel three-dimensional (3D) pre-operative planning technique as the difficulties likely to be encountered were detected and solved pre-operatively by adapting the surgical procedure and choosing the optimal implants which would best restore the hip biomechanics [11][12][13][14]. However, it is not clear whether this technique helped to decrease the complications rate with respect to intra-operative fractures, dislocation risk and complaints about lower limb discrepancy (LLD).…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Sariali

Catonné

Pascal‐Moussellard

2016

International Orthopaedics (SICOT)

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Purpose The direct anterior approach is an attractive option for total hip arthroplasty (THA) in order to achieve a quicker rehabilitation. However, this surgical technique presents a longer learning curve and a higher complications rate compared with the standard approach. We investigated whether three-dimensional (3D) planning anticipated the surgical difficulties and helped to achieve a low complications rate with respect to intra-operative complications, dislocation risk and lower limb discrepancy (LLD). Methods One hundred and fifty-four consecutive patients underwent a primary cementless THA using a direct anterior approach. A 3D planning was performed in order to anticipate the difficulties that may be encountered regarding femur perforation or fracture, dislocation and LLD. All patients were assessed at a mean five years' follow-up. Results No false route and no fracture occurred at the time of surgery. All the surgical difficulties were anticipated. A motorised reaming procedure of the femur was required in six patients because of a very dense bone or a narrow femur. A retroverted neck was used in 7 % of patients because of a torsional abnormality and enabled an increase in stability. The real implant sizes were the same as the ones planned in 97 % for the cup, 96 % for the stem and 100 % for the neck. At five years' follow-up, no dislocation occurred, no patient complained about LLD and excellent clinical outcomes were achieved. Conclusions This study demonstrates that 3D pre-operative planning-guided THA through a minimally invasive direct anterior approach is a safe and accurate procedure.Level of Evidence: Level IV

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Sariali

Catonné

Pascal‐Moussellard

2016

International Orthopaedics (SICOT)

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“…Of note, it is our practice to take great care with dry assembly of the neck-stem junction on the back table [16]. We selected the best neck option based on preoperative 3D CT findings [9].…”

Section: Discussionmentioning

confidence: 99%

“…The procedure was planned using 3D computed tomography (CT) and HIP-PLAN software (Symbios, Yverdon-les-Bains, Switzerland) [9]. A direct anterior approach was used.…”

Section: Case Reportmentioning

confidence: 99%

Adverse tissue reaction to corrosion at the neck-stem junction after modular primary total hip arthroplasty

Gkagkalis¹,

Mettraux²,

Omoumi³

et al. 2015

Orthopaedics & Traumatology: Surgery & Research

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Complications related to the neck-stem junction of modular stems used for total hip arthroplasty (THA) are generating increasing concern. A 74-year-old male had increasing pain and a cutaneous reaction around the scar 1 year after THA with a modular neck-stem. Imaging revealed osteolysis of the calcar and a pseudo-tumour adjacent to the neck-stem junction. Serum cobalt levels were elevated. Revision surgery to exchange the stem and liner and to resect the pseudo-tumour was performed. Analysis of the stem by scanning electron microscopy and by energy dispersive X-ray and white light interferometry showed fretting corrosion at the neck-stem junction contrasting with minimal changes at the head-neck junction. Thus, despite dry assembly of the neck and stem on the back table at primary THA, full neck-stem contact was not achieved, and the resulting micromotion at the interface led to fretting corrosion. This case highlights the mechanism of fretting corrosion at the neck-stem interface responsible for adverse local tissue reactions. Clinical and radiological follow-up is mandatory in patients with dual-modular stems.

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“…If the accuracy is extended to predict to one size, the value is increased to 60-94% [15,25]. Therefore, computed tomography (CT) scans were developed, demonstrating a clearly higher accuracy in size prediction (estimated at 94-100%) [13,30,31]. In the present study, we used the "modiCAS|3D ® -software" (modiCAS GmbH, Erlangen, Germany) for 3D templating based on a preoperative CT scan.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

Savov

Budde

Tsamassiotis

et al. 2020

Arch Orthop Trauma Surg

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Introduction Computed tomography-based three-dimensional models may allow the accurate determination of the center of rotation, lateral and anterior femoral offsets, and the required implant size in total hip arthroplasty. In this cadaver study, the accuracy of anatomical reconstruction was evaluated using a three-dimensional planning tool. Materials and methods A total of eight hip arthroplasties were performed on four bilateral specimens. Based on a computed tomography scan, the position and size of the prosthesis were templated with respect to the anatomical conditions. Results On average, all parameters were reconstructed to an accuracy of 4.5 mm and lie within the limits recommended in the literature. All prostheses were implanted with the templated size. Conclusions The exact anatomy of the patient and the required size and position of the prosthesis were precisely analyzed using a templating software. Based on the present findings, the development of template-directed instrumentation is conceivable using this method. However, further technical features (e.g., navigation or robot-assisted surgery) are required for improved precision for implant positioning.

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Comparisons of Preoperative Three-Dimensional Planning and Surgical Reconstruction in Primary Cementless Total Hip Arthroplasty

Cited by 78 publications

References 21 publications

Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Adverse tissue reaction to corrosion at the neck-stem junction after modular primary total hip arthroplasty

Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

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