Pre-operative planning and templating with 3-D printed models for complex primary and revision total hip arthroplasty

Maryada, Venkateshwar Reddy; Mulpur, Praharsha; Eachempati, Krishna Kiran; Annapareddy, Adarsh; Prasad, Vemaganti Badri Narayana; Reddy, A.V. Gurava

doi:10.1016/j.jor.2022.09.004

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…Accurate planning and 3D anatomical models could help in assessing acetabular bone deficiencies reliably in rTHA [ 31 ]. Restoring the correct CoR and acetabular position is an important goal to avoid wear of the prosthesis components, risk of aseptic loosening, and risk of malfunction of the abductor muscles.…”

Section: Discussionmentioning

confidence: 99%

Custom-made implants for massive acetabular bone loss: accuracy with CT assessment

Romagnoli,

Zaffagnini,

Carillo

et al. 2023

J Orthop Surg Res

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Background Custom-made implants are a valid option in revision total hip arthroplasty to address massive acetabular bone loss. The aim of this study was to assess the accuracy of custom-made acetabular implants between preoperative planning and postoperative positioning using CT scans. Methods In a retrospective analysis, three patients who underwent an acetabular custom-made prosthesis were identified. The custom-made designs were planned through 3D CT analysis considering surgical points of attention. The accuracy of intended implants positioning was assessed by comparing pre- and postoperative CT analyzing the center of rotation (CoR), anteversion, inclination, screws, and implant surface in contact with the bone. Results The three cases presented satisfactory accuracy in positioning. A malpositioning in the third case was observed due to the posterization of the CoR of the implant of more than 10 mm. The other CoR vectors considered in the third patient and all vectors in the other two cases fall within 10 mm. All the cases were positioned with a difference of less than 10° of anteversion and inclination with respect to the planning. Conclusions The current case series revealed promising accuracy in the positioning of custom-made acetabular prosthesis comparing the planned implant in preoperative CT with postoperative CT.

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Section: Discussionmentioning

confidence: 99%

Custom-made implants for massive acetabular bone loss: accuracy with CT assessment

Romagnoli,

Zaffagnini,

Carillo

et al. 2023

J Orthop Surg Res

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show abstract

“…There is little literature available to date regarding the accuracy of preoperative planning for revision arthroplasty. Most studies on preoperative planning in revision arthroplasty focus on 3D printing or patient-specific implants [ 17 , 18 , 19 ]. However, these two procedures are associated with significantly higher costs [ 20 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Maryada et al were able to simulate and plan the correct implant size and positioning of the acetabular cup through printed anatomical 3D models. Accurate placement of the acetabular cup in complex primary and revision total hip replacement was achieved in 93% of cases ( n = 27) [ 17 ]. These findings match our results for 3D templating of reinforcement cages.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Accuracy of 2D and 3D Templating for Revision Total Hip Replacement

Winter

Fritsch

König

et al. 2023

JPM

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Introduction: Revision hip arthroplasty is a challenging surgical procedure, especially in cases of advanced acetabular bone loss. Accurate preoperative planning can prevent complications such as periprosthetic fractures or aseptic loosening. To date, the accuracy of three-dimensional (3D) versus two-dimensional (2D) templating has been evaluated only in primary hip and knee arthroplasty. Methods: We retrospectively investigated the accuracy of 3D personalized planning of reinforcement cages (Burch Schneider) in 27 patients who underwent revision hip arthroplasty. Personalized 3D modeling and positioning of the reinforcement cages were performed using computed tomography (CT) of the pelvis of each patient and 3D templates of the implant. To evaluate accuracy, the sizes of the reinforcement cages planned in 2D and 3D were compared with the sizes of the finally implanted cages. Factors that may potentially influence planning accuracy such as gender and body mass index (BMI) were analyzed. Results: There was a significant difference (p = 0.003) in the accuracy of correct size prediction between personalized 3D templating and 2D templating. Personalized 3D templating predicted the exact size of the reinforcement cage in 96.3% of the patients, while the exact size was predicted in only 55.6% by 2D templating. Regarding gender and BMI, no statistically significant differences in planning accuracy either for 2D or 3D templating were observed. Conclusion: Personalized 3D planning of revision hip arthroplasty using Burch Schneider reinforcement cages leads to greater accuracy in the prediction of the required size of implants than conventional 2D templating.

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“…Making three-dimensional models provides both visual and tactile reproduction of bone anatomy, with the potential for better preoperative planning, thus helping to make complex interventions more precise and accurate. 4 3D-printing and virtual surgery planning have found significant interest in the field of orthopaedics, leading to considerable advancement in preoperative surgical planning. [5][6][7] Indeed, it is found that 3D models allow surgeons to visualize anatomy three-dimensionally and aid in the planning and execution of complex surgeries.…”

Section: Introductionmentioning

confidence: 99%

3D-printing of porous structures for reproduction of a femoral bone

et al. 2023

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Background: 3D-printing has shown potential in several medical advances because of its ability to create patient-specific surgical models and instruments. In fact, this technology makes it possible to acquire and study physical models that accurately reproduce patient-specific anatomy. The challenge is to apply 3D-printing to reproduce the porous structure of a bone tissue, consisting of compact bone, spongy bone and bone marrow. Methods: An interesting approach is presented here for reproducing the structure of a bone tissue of a femur by 3D-printing porous structure. Through the process of CT segmentation, the distribution of bone density was analysed. In 3D-printing, the bone density was compared with the density of infill. Results: The zone of compact bone, the zone of spongy bone and the zone of bone marrow can be recognized in the 3D printed model by a porous density additive manufacturing method. Conclusions: The application of 3D-printing to reproduce a porous structure, such as that of a bone, makes it possible to obtain physical anatomical models that likely represent the internal structure of a bone tissue. This process is low cost and easily reproduced.

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Pre-operative planning and templating with 3-D printed models for complex primary and revision total hip arthroplasty

Cited by 8 publications

References 17 publications

Custom-made implants for massive acetabular bone loss: accuracy with CT assessment

Custom-made implants for massive acetabular bone loss: accuracy with CT assessment

Comparison of the Accuracy of 2D and 3D Templating for Revision Total Hip Replacement

3D-printing of porous structures for reproduction of a femoral bone

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