3D-printed Patient-specific Guides for Hip Arthroplasty

Henckel, Johann; Holme, Thomas J; Radford, Warwick; Skinner, John; Hart, Alister

doi:10.5435/jaaos-d-16-00719

Cited by 53 publications

(22 citation statements)

References 32 publications

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“…The guide is removed, leaving the two pins to act as either a constrained or unconstrained guide to reaming and component placement ( a ). The femoral guide has a contoured fit to the femoral neck/head and is kept in place for the neck cut by two intraosseous pins ( b ) [ 13 ] …”

Section: Methodsmentioning

confidence: 99%

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Can 3D surgical planning and patient specific instrumentation reduce hip implant inventory? A prospective study

et al. 2020

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Background Modern designs of joint replacements require a large inventory of components to be available during surgery. Pre-operative CT imaging aids 3D surgical planning and implant sizing, which should reduce the inventory size and enhance clinical outcome. We aimed to better understand the impact of the use of 3D surgical planning and Patient Specific Instrumentation (PSI) on hip implant inventory. Methods An initial feasibility study of 25 consecutive cases was undertaken to assess the discrepancy between the planned component sizes and those implanted to determine whether it was possible to reduce the inventory for future cases. Following this, we performed a pilot study to investigate the effect of an optimized inventory stock on the surgical outcome: we compared a group of 20 consecutive cases (experimental) with the 25 cases in the feasibility study (control). We assessed: (1) accuracy of the 3D planning system in predicting size (%); (2) inventory size changes (%); (3) intra and post-operative complications. Results The feasibility study showed variability within 1 size range, enabling us to safely optimize inventory stock for the pilot study. (1) 3D surgical planning correctly predicted sizes in 93% of the femoral and 89% of the acetabular cup components; (2) there was a 61% reduction in the implant inventory size; (3) we recorded good surgical outcomes with no difference between the 2 groups, and all patients had appropriately sized implants. Conclusions 3D planning is accurate in up to 95% of the cases. CT-based planning can reduce inventory size in the hospital setting potentially leading to a reduction in costs.

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Section: Methodsmentioning

confidence: 99%

“…The digital plan can be transferred to patient care by way of 3D printed personalised instruments and surgical guides, so-called Patient-Specific Instruments (PSI) [ 11 , 12 ]. 3D printed, sterilised and used intraoperatively, the physical models aid the surgeon achieving optimal cup and stem sizing and positioning [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Can 3D surgical planning and patient specific instrumentation reduce hip implant inventory? A prospective study

et al. 2020

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“…It is important to identify the areas of expertise that have the greatest potential for the integration of 3D printing technology. The Radiological Society of North America 3D printing group (3D Special Interest Group RSNA) has reviewed and classified the clinical cases in which it is more efficient to use 3D printed biomodels, and has concluded that in simple fractures the role of 3D printing is not as useful as in complex fractures, hip dysplasia or bone tumours with joint involvement [34]. In our study, Reconstructive Surgery, which included deformities, degenerative joint pathology, infections or arthroplasties, Traumatology, which managed fractures of any anatomical location or age of presentation, and Orthopedic Oncology, represented 53.77% of the global activity.…”

Section: Discussionmentioning

confidence: 99%

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from “do it yourself” to “point of care manufacturing”

Calvo-Haro

Pascau

Mediavilla-Santos

et al. 2021

BMC Musculoskelet Disord

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Background 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and to identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine. Methods Observational, descriptive, retrospective and monocentric study of a total of 623 additive manufacturing processes carried out in a Department of Orthopedic Surgery and Traumatology from November 2015 to March 2020. Variables such as product type, utility, time or materials for manufacture were analyzed. Results The areas of expertise that have performed more processes are Traumatology, Reconstructive and Orthopedic Oncology. Pre-operative planning is their primary use. Working and 3D printing hours, as well as the amount of 3D printing material used, vary according to the type of product or material delivered to perform the process. The most commonly used 3D printing material for manufacturing is polylactic acid, although biocompatible resin has been used to produce surgical guides. In addition, the hospital has worked on the co-design of customized implants with manufacturing companies. Conclusions The integration of 3D printing in a Department of Orthopedic Surgery and Traumatology allows identifying the conceptual evolution from “Do-It-Yourself” to “POC manufacturing”.

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“…In addition, computer-aided design is a widespread tool for biological structure modelling [7][8][9], and its later use for disease diagnosis [10,11]. Our research group have developed some new virtual geometric models of the human cornea that have been used to characterize corneal ectasia disease basing on Amsler-Krumeich classification [12][13][14], and for other classification, named RETICS [15], which allows characterizing keratoconus' pathology considering visual performance of patients in its initial phases [16,17].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Morpho-Geometrical Analysis of the Corneal Surfaces in Keratoconus Disease According to Moderate Visual Limitation

Cavas

Fernández-Pacheco

Barrio

et al. 2020

Lecture Notes in Mechanical Engineering

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The cornea is a complex hemispheric structure, made of collagen fibres that provide it a homogenous and stable geometry. During keratoconus disease, a loss of tenacity takes place in the collagen fibres that form the corneal structure, producing an alteration of its geometry, this is, a change of its curvature, and therefore, a loss of visual quality of patients. The geometric characterization of the hemispheric structure by means of biometric parameters is a very solid technique of diagnosis, based in a virtual 3D model, which has already been validated for several degrees of severity of keratoconus pathology. In this prospective comparative study, 93 corneas (50 healthy subjects and 43 patients with keratoconus with moderate visual limitation) were geometrically modelled. The results obtained in this work suggest that the best predictive biometric parameters are anterior corneal surface area and posterior apex deviation, and that the strongest correlation is produced between sagittal plane apex area in minimum thickness point and sagittal plane apex area. The studied biometric parameters have shown significant differences between groups. Therefore, the analysis of the biometric parameters that register the geometric decompensation that locally appear in a corneal region, as a response to the asymmetry produced during the development of keratoconus disease with a moderate visual impairment, is a new approach that may lead to a better understanding of the disease with this degree of optical limitation.

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3D-printed Patient-specific Guides for Hip Arthroplasty

Cited by 53 publications

References 32 publications

Can 3D surgical planning and patient specific instrumentation reduce hip implant inventory? A prospective study

Can 3D surgical planning and patient specific instrumentation reduce hip implant inventory? A prospective study

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from “do it yourself” to “point of care manufacturing”

Efficacy of Morpho-Geometrical Analysis of the Corneal Surfaces in Keratoconus Disease According to Moderate Visual Limitation

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