Preliminary application of computer‐assisted patient‐specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip

Zhang, Yuan Z.; Chen, Bin; Lu, Sheng; Yang, Yong; Zhao, Jian; Li, Rui; Li, Yan B.; Pei, Guo X.

doi:10.1002/rcs.423

Cited by 67 publications

(48 citation statements)

References 36 publications

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“…PSI were developed originally for total knee arthroplasty [22, 23] with some residual controversy in terms of the achieved bone-cutting accuracy [24, 25]. Recently, other PSI-assisted applications such as pedicle screw insertion [26–28], hip arthroplasty [29, 30], and corrective osteotomy [31–33] have been described in the literature. PSI technology has been adapted also for bone tumor surgery [34–36]: the patient-specific cutting guides are equipped with bone-specific surfaces to fit into unique position on the patient and flat surfaces to materialize the desired resection planes.…”

Section: Introductionmentioning

confidence: 99%

Computer-Assisted Planning and Patient-Specific Instruments for Bone Tumor Resection within the Pelvis: A Series of 11 Patients

Gouin

Laurent

Odri

et al. 2014

Sarcoma

112

105

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Pelvic bone tumor resection is challenging due to complex geometry, limited visibility, and restricted workspace. Accurate resection including a safe margin is required to decrease the risk of local recurrence. This clinical study reports 11 cases of pelvic bone tumor resected by using patient-specific instruments. Magnetic resonance imaging was used to delineate the tumor and computerized tomography to localize it in 3D. Resection planning consisted in desired cutting planes around the tumor including a safe margin. The instruments were designed to fit into unique position on the bony structure and to indicate the desired resection planes. Intraoperatively, instruments were positioned freehand by the surgeon and bone cutting was performed with an oscillating saw. Histopathological analysis of resected specimens showed tumor-free bone resection margins for all cases. Available postoperative computed tomography was registered to preoperative computed tomography to measure location accuracy (minimal distance between an achieved and desired cut planes) and errors on safe margin (minimal distance between the achieved cut planes and the tumor boundary). The location accuracy averaged 2.5 mm. Errors in safe margin averaged −0.8 mm. Instruments described in this study may improve bone tumor surgery within the pelvis by providing good cutting accuracy and clinically acceptable margins.

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Section: Introductionmentioning

confidence: 99%

Computer-Assisted Planning and Patient-Specific Instruments for Bone Tumor Resection within the Pelvis: A Series of 11 Patients

Gouin

Laurent

Odri

et al. 2014

Sarcoma

112

105

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“…A promising prospect has been shown in clinical application [9,10]. The error range can be controlled to 0.1 mm [25].…”

Section: Discussionmentioning

confidence: 99%

“…Finding a way to improve the precision of necrotic area locations should reduce the damage caused by multiple punctures and X-ray exposure and the success rate should increase. With the development of computer-assisted orthopedic surgery, computer-assisted techniques are more and more widely applied in high-precision orthopedic surgeries [10–12]. …”

Section: Introductionmentioning

confidence: 99%

Patient-specific core decompression surgery for early-stage ischemic necrosis of the femoral head

Wang

Yang

et al. 2017

PLoS ONE

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IntroductionCore decompression is an efficient treatment for early stage ischemic necrosis of the femoral head. In conventional procedures, the pre-operative X-ray only shows one plane of the ischemic area, which often results in inaccurate drilling. This paper introduces a new method that uses computer-assisted technology and rapid prototyping to enhance drilling accuracy during core decompression surgeries and presents a validation study of cadaveric tests.MethodsTwelve cadaveric human femurs were used to simulate early-stage ischemic necrosis. The core decompression target at the anterolateral femoral head was simulated using an embedded glass ball (target). Three positioning Kirschner wires were drilled into the top and bottom of the large rotor. The specimen was then subjected to computed tomography (CT). A CT image of the specimen was imported into the Mimics software to construct a three-dimensional model including the target. The best core decompression channel was then designed using the 3D model. A navigational template for the specimen was designed using the Pro/E software and manufactured by rapid prototyping technology to guide the drilling channel. The specimen-specific navigation template was installed on the specimen using positioning Kirschner wires. Drilling was performed using a guide needle through the guiding hole on the templates. The distance between the end point of the guide needle and the target was measured to validate the patient-specific surgical accuracy.ResultsThe average distance between the tip of the guide needle drilled through the guiding template and the target was 1.92±0.071 mm.ConclusionsCore decompression using a computer-rapid prototyping template is a reliable and accurate technique that could provide a new method of precision decompression for early-stage ischemic necrosis.

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“…PST uses preoperative 3D images and has been applied to acetabular cup placement guide in THA and femoral guide wire insertion for hip resurfacing6061626364). However, it requires preoperative CT evaluation, a higher expense of producing the template and skill for optimal and precise preoperative planning.…”

Section: Applications Of Caos In Thamentioning

confidence: 99%

“…10), various clinical studies are being carried out to verify the effectiveness and safety of these devices606162636465).…”

Section: Recent Evolution In Caos For Thamentioning

confidence: 99%

The Evolution of Computer-Assisted Total Hip Arthroplasty and Relevant Applications

et al. 2017

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In total hip arthroplasty (THA), the accurate positioning of implants is the key to achieve a good clinical outcome. Computer-assisted orthopaedic surgery (CAOS) has been developed for more accurate positioning of implants during the THA. There are passive, semi-active, and active systems in CAOS for THA. Navigation is a passive system that only provides information and guidance to the surgeon. There are 3 types of navigation: imageless navigation, computed tomography (CT)-based navigation, and fluoroscopy-based navigation. In imageless navigation system, a new method of registration without the need to register the anterior pelvic plane was introduced. CT-based navigation can be efficiently used for pelvic plane reference, the functional pelvic plane in supine which adjusts anterior pelvic plane sagittal tilt for targeting the cup orientation. Robot-assisted system can be either active or semi-active. The active robotic system performs the preparation for implant positioning as programmed preoperatively. It has been used for only femoral implant cavity preparation. Recently, program for cup positioning was additionally developed. Alternatively, for ease of surgeon acceptance, semi-active robot systems are developed. It was initially applied only for cup positioning. However, with the development of enhanced femoral workflows, this system can now be used to position both cup and stem. Though there have been substantial advancements in computer-assisted THA, its use can still be controversial at present due to the steep learning curve, intraoperative technical issues, high cost and etc. However, in the future, CAOS will certainly enable the surgeon to operate more accurately and lead to improved outcomes in THA as the technology continues to evolve rapidly.

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Preliminary application of computer‐assisted patient‐specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip

Cited by 67 publications

References 36 publications

Computer-Assisted Planning and Patient-Specific Instruments for Bone Tumor Resection within the Pelvis: A Series of 11 Patients

Computer-Assisted Planning and Patient-Specific Instruments for Bone Tumor Resection within the Pelvis: A Series of 11 Patients

Patient-specific core decompression surgery for early-stage ischemic necrosis of the femoral head

The Evolution of Computer-Assisted Total Hip Arthroplasty and Relevant Applications

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