Qiang Tu1,2,3, Huan-Wen Ding4,5, Hu Chen2,3, Jian-Jian Shen6, Qiu-Ju Miao4, Bao Liu7, Guang-Wen Yu8, Xian-Hua Huang2, Chang-Rong Zhu2, Yong Tang1, Hong Xia2, Jian-Zhong Xu1. 1. Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China. 2. Department of Orthopaedics, General Hospital of Southern Theatre Command of PLA, Guangzhou, China. 3. Department of Orthopaedics, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China. 4. Department of Anatomy, School of Medicine, South China University of Technology, Guangzhou, China. 5. Department of Orthopaedics, Guangzhou First People's Hospital, Guangzhou, China. 6. Department of Spinal Surgery, Guangdong Integrative Medicine Hospital, Foshan, China. 7. Department of Orthopaedics, Zhongshan Torch Development Zone Hospital, Zhongshan, China. 8. Department of Sports Medicine, Guangzhou Orthopaedics Hospital, Guangzhou, China.
Abstract
OBJECTIVE: To evaluate the feasibility and accuracy of three-dimensional (3D)-printed individualised guiding templates in total hip arthroplasty (THA) for the treatment of developmental dysplasia of the hip (DDH). METHODS: 12 hips in 12 patients with Crowe type IV DDH were treated with THA. A 3D digital model of the pelvis and lower limbs was reconstructed using the computed tomography data of the patients. Preoperative surgical simulations were performed to determine the most suitable surgical planning, including femoral osteotomy and prosthesis placement. Based on the ideal surgical planning, individualised guiding templates were designed by software, manufactured using a 3D printer, and used in acetabulum reconstruction and femoral osteotomy during surgery. RESULTS: 12 patients were followed up for an average of 72.42 months (range 38-135 months). During surgery, the guiding template for each case was matched to the bony markers of the acetabulum and proximal femur. Preoperative and follow-up Harris Hip Scores were 34.2 ± 3.7 and 85.2 ± 4.2; leg-length discrepancy, 51.5 ± 6.5 mm and 10.2 ± 1.5 mm; and visual analogue scale scores, 6.2 ± 0.8 and 1.3 ± 0.3, respectively, with statistical difference. Shortened deformity and claudication of the affected limb were obviously improved after surgery. However, 1 patient had artificial hip dislocation 2 weeks after surgery, and another patient had sciatic nerve traction injury, both of whom recovered after physical treatment. CONCLUSIONS: Preoperative surgical simulation and 3D-printed individualised guiding templates can fulfil surgeon-specific requirements for the treatment of Crowe type IV DDH. Accurate THA can be achieved using 3D-printed individualised templates, which provide a new personalised surgical plan for the precise positioning and orientation of acetabular reconstruction and femoral osteotomy.
OBJECTIVE: To evaluate the feasibility and accuracy of three-dimensional (3D)-printed individualised guiding templates in total hip arthroplasty (THA) for the treatment of developmental dysplasia of the hip (DDH). METHODS: 12 hips in 12 patients with Crowe type IV DDH were treated with THA. A 3D digital model of the pelvis and lower limbs was reconstructed using the computed tomography data of the patients. Preoperative surgical simulations were performed to determine the most suitable surgical planning, including femoral osteotomy and prosthesis placement. Based on the ideal surgical planning, individualised guiding templates were designed by software, manufactured using a 3D printer, and used in acetabulum reconstruction and femoral osteotomy during surgery. RESULTS: 12 patients were followed up for an average of 72.42 months (range 38-135 months). During surgery, the guiding template for each case was matched to the bony markers of the acetabulum and proximal femur. Preoperative and follow-up Harris Hip Scores were 34.2 ± 3.7 and 85.2 ± 4.2; leg-length discrepancy, 51.5 ± 6.5 mm and 10.2 ± 1.5 mm; and visual analogue scale scores, 6.2 ± 0.8 and 1.3 ± 0.3, respectively, with statistical difference. Shortened deformity and claudication of the affected limb were obviously improved after surgery. However, 1 patient had artificial hip dislocation 2 weeks after surgery, and another patient had sciatic nerve traction injury, both of whom recovered after physical treatment. CONCLUSIONS: Preoperative surgical simulation and 3D-printed individualised guiding templates can fulfil surgeon-specific requirements for the treatment of Crowe type IV DDH. Accurate THA can be achieved using 3D-printed individualised templates, which provide a new personalised surgical plan for the precise positioning and orientation of acetabular reconstruction and femoral osteotomy.
Entities:
Keywords:
Developmental dysplasia of the hip; guiding template. 3D printing; total hip arthroplasty
Authors: Ahmed Habib; Nicolina Jovanovich; Nallammai Muthiah; Ali Alattar; Nima Alan; Nitin Agarwal; Alp Ozpinar; David Kojo Hamilton Journal: Eur Spine J Date: 2022-05-19 Impact factor: 2.721