Preliminary application of 3D-printed individualised guiding templates for total hip arthroplasty in Crowe type IV developmental dysplasia of the hip.

Published on Aug 4, 2020in Hip International2.135
· DOI :10.1177/1120700020948006
Sources
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.
References14
Newest
#1Dimitri E. Delagrammaticas (NU: Northwestern University)H-Index: 6
#2George Ochenjele (NU: Northwestern University)H-Index: 4
Last. Michael D. Stover (NU: Northwestern University)H-Index: 18
view all 6 authors...
Introduction:Intraoperative radiographic evaluation during total hip arthroplasty (THA) has shown to improve the accuracy of acetabular component placement, however, differences in interpretation b...
Source
#1Keisuke Komiyama (Kyushu University)H-Index: 6
#2Jun ichi Fukushi (Kyushu University)H-Index: 22
Last. Yasuharu Nakashima (Kyushu University)H-Index: 39
view all 7 authors...
Background To achieve sufficient socket coverage by the native bone, high placement of cementless acetabular cup is often required. We previously reported, using computer simulation, that higher hip centre improved the bone coverage but decreased the range of motion in total hip arthroplasty (THA) for patients with hip dysplasia. However, in a clinical setting, the correlation between the hip centre height and dislocation after primary THA is still unclear. We examined whether a high hip centre ...
Source
#2Fahri Erdogan (Istanbul University)H-Index: 7
Last. Gokhan Kaynak (Istanbul University)H-Index: 11
view all 3 authors...
Abstract Background Long-term favorable clinical outcomes of anatomical or high hip center techniques in total hip arthroplasty (THA) are reported in patients with developmental dysplasia of the hip (DDH). However, there is little information about the effect of the hip center location on gait characteristics. The purpose of this study was to compare these surgical techniques with gait analysis, analyze the effect of the hip rotation center location on gait parameters, and discuss the possible p...
Source
#1Xiao-Tong Shi (JLU: Jilin University)H-Index: 3
#2Chao-Feng Li (JLU: Jilin University)H-Index: 3
Last. Jian-Guo Liu (JLU: Jilin University)H-Index: 9
view all 6 authors...
: Developmental dysplasia of the hip (DDH) is accompanied by morphological alterations on both the acetabular and the femoral side. Total hip arthroplasty (THA) provides effective treatment in cases of neglected DDH but requires elaborate preoperative planning. To determine the morphological changes resulting from the dysplasia, the anatomic acetabular position, the height of the femur head dislocation, the height of the femur head dislocation, and the combined anteversion must all be establishe...
Source
#1Lauren J Seo (HSS: Hospital for Special Surgery)H-Index: 1
#2Jonathan A. Gabor (HSS: Hospital for Special Surgery)H-Index: 7
Last. Jonathan M. Vigdorchik (HSS: Hospital for Special Surgery)H-Index: 23
view all 6 authors...
Background Patients with developmental dysplasia of the hip (DDH) require special surgical considerations for total hip arthroplasty (THA). Despite the difficulties posed by the population’s anatomical abnormalities, few large evaluations of postoperative outcomes exist. This study seeks to characterize outcomes following primary THA among patients diagnosed with DDH.
Source
#1Jun ichi Fukushi (Kyushu University)H-Index: 22
#2Ichiro Kawano (Kyushu University)H-Index: 2
Last. Yasuharu Nakashima (Kyushu University)H-Index: 39
view all 6 authors...
Abstract Background In total hip arthroplasty (THA), placing the cup in an anatomic position is not always possible in case of deformities related to developmental dysplasia of the hip (DDH). Thus far, the influence of a hip center on the abductor moment after THA has not been clearly elucidated. Therefore, we performed a retrospective study to assess (1) how abductor muscle moment recovers postoperatively in THA and (2) whether acetabular cup position affects the recovery of abductor moment. Hy...
Source
#1Vincent P. Galea (Harvard University)H-Index: 9
#2Inari Laaksonen (Harvard University)H-Index: 6
Last. Charles R. Bragdon (Harvard University)H-Index: 57
view all 7 authors...
Abstract Background The primary aim of this study was to determine the clinical outcomes at 13-year follow-up of patients diagnosed with developmental dysplasia of the hip and subsequently treated with total hip arthroplasty (THA). The secondary aim was to investigate the effect of hip center location on clinical outcomes and polyethylene wear. Methods We reviewed data from a consecutive series of 104 patients (123 hips) from a single center. Patients were treated with THA with the high hip cent...
Source
#1Maurizio MontaltiH-Index: 4
Last. A. ToniH-Index: 55
view all 6 authors...
Abstract Background Total hip arthroplasty (THA) in severe developmental dysplasia of the hip (DDH) is a challenging procedure. The most used techniques involve anatomic cup positioning, augmentation femoral osteotomy. However, anatomic cup positioning is not always feasible in severe DDH and osteotomy nonunion may ensue. The purpose of the study was to assess the survivorship, the hip score results, the radiological parameters (fixation, loosening, component position) of a large cohort of patie...
Source
#1Hernan A. Prieto (Mayo Clinic)H-Index: 9
#2Michael E. Kralovec (Mayo Clinic)H-Index: 5
Last. Miguel E. Cabanela (Mayo Clinic)H-Index: 58
view all 6 authors...
Abstract Background Revision total hip arthroplasty (THA) is challenging specially in the presence of severe acetabular bone deficiency. We report the use of a highly porous revision shell augmented by structural allograft to provide structural support and coverage to the acetabular component. Methods We identified 56 patients (58 hips) undergoing revision THA, where a trabecular metal revision cup was supported by structural allograft. Mean follow-up was 5.4 years (range 2-12 years). Preoperati...
Source
#1Eric M. Greber (UofU: University of Utah)H-Index: 2
#2Christopher E. Pelt (UofU: University of Utah)H-Index: 22
Last. Christopher L. Peters (UofU: University of Utah)H-Index: 59
view all 6 authors...
Abstract Background Developmental dysplasia of the hip (DDH) is a recognized cause of secondary arthritis, which may eventually lead to total hip arthroplasty (THA). An understanding of the common acetabular and femoral morphologic abnormalities will aid the surgeon in preparing for the complexity of the surgical case. Methods We present the challenges associated with acetabular and femoral morphologies that may be present in the dysplastic hip and discuss surgical options to consider when perfo...
Source
Cited By0
Newest
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.