Application of computer-assisted virtual surgical procedures and three-dimensional printing of patient-specific pre-contoured plates in bicolumnar acetabular fracture fixation

Chen, Kaifang; Yang, Fan; Yao, Sheng; Xiong, Zekang; Sun, Tingfang; Zhu, Fengzhao; Telemacque, Dionne; Drepaul, Deepak; Ren, Zhengwei; Guo, Xiaodong

doi:10.1016/j.otsr.2019.05.011

Cited by 35 publications

(64 citation statements)

References 19 publications

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“…The anterior column-posterior hemitransverse fracture pattern with protrusion of the femoral head and medial migration of the QLS is prevalent in the growing elderly population. Anatomical reduction resulting in a congruent hip joint is the ultimate goal, but adequate internal fixation can maintain fracture reduction and allow painless early mobility until fracture-healing is achieved 5 , 18 , 21 . The choice of internal fixation for such acetabular fractures involving the QLS (suprapectineal or infrapectineal plating fixation and periarticular long screws or QLS buttress plating fixation) is controversial.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of Different Fixation Techniques for Typical Acetabular Fractures in the Elderly

Chen

Yang

Yao

et al. 2020

Journal of Bone and Joint Surgery

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Background: Anterior column-posterior hemitransverse fractures are prevalent in the elderly and are often associated with quadrilateral surface (QLS) comminution. Several special QLS buttress plates have been introduced, but evidence of their comparability with traditional fixation devices is lacking. This biomechanical study aimed to compare special QLS buttress plates with traditional fixation devices. Methods: Anterior column-posterior hemitransverse fractures with an isolated QLS fragment were created on 24 composite hemipelves and were allocated to 4 fixation groups: (1) infrapectineal QLS buttress plate, (2) suprapectineal QLS buttress plate, (3) suprapectineal reconstruction plate with 3 periarticular long screws, and (4) infrapectineal reconstruction plate with 3 periarticular long screws. Specimens were loaded to simulate partial weight-bearing (35 to 350 N) or full weight-bearing (75 to 750 N). A testing machine was synchronized with a 3-dimensional video tracking system to optically track displacement at the points of interest and to calculate construct stiffness. The fixation systems were compared using the Kruskal-Wallis and Mann-Whitney U tests. Results: The experimental results of the partial and full weight-bearing simulations were surprisingly similar. During 40 loading cycles, the maximum displacement on the 6 predetermined points did not exceed 1.1 mm. Multiple-group comparisons of relative displacements of each predetermined measurement point did not differ significantly (p > 0.05). The suprapectineal reconstruction plate with 3 periarticular long screws demonstrated the greatest construct stiffness and significantly greater stiffness than the infrapectineal plate with long screws (p < 0.017). However, no significant difference (p > 0.017) in stiffness was identified between the infrapectineal QLS buttress plate and the suprapectineal reconstruction plate with long screws. Conclusions: The suprapectineal pelvic brim plate with 3 periarticular long screws remains the gold standard to treat anterior column-posterior hemitransverse fractures. The special infrapectineal QLS buttress plate provides stiffness and stability comparable with those of standard fixation. However, moving the pelvic brim plate from the suprapectineal border to the infrapectineal border is not recommended for anterior column-posterior hemitransverse fractures because it significantly decreases fixation stiffness. Clinical Relevance: Special QLS buttress plates may be an alternative fixation method for anterior column-posterior hemitransverse acetabular fractures in the elderly, especially when a less invasive anterior intrapelvic approach is selected.

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Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of Different Fixation Techniques for Typical Acetabular Fractures in the Elderly

Chen

Yang

Yao

et al. 2020

Journal of Bone and Joint Surgery

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“…Seven papers, i.e., 23.33% of all included studies, are retrospective non-randomized series of cases [ 19 , 20 , 23 , 24 , 28 , 29 , 38 ]. In these papers, 3D prints were used as templates for plate precontouring for 128 patients out of 233 patients surgically treated.…”

Section: Resultsmentioning

confidence: 99%

“…The MINORS (Methodological Index for Non-Randomized Studies) scale was used for assessing the methodological quality for the comparative. Two studies were of level II of evidence [ 30 , 31 ], five of level III [ 20 , 23 , 24 , 28 , 29 ], most case series (thirteen) were of level IV and the remaining ten were of level V.…”

Section: Resultsmentioning

confidence: 99%

“…Chen et al [ 20 ] also reported blood loss reduction (696.07 ± 166.54 mL vs. 833.75 ± 227.44 mL) and surgery time decrease (157.5 ± 20.48 min vs. 157.5 ± 20.48 min), but no statistically significant differences in reduction quality (Matta score) of scoring of hip function scoring (Merle d’Aubigné score).…”

Section: Resultsmentioning

confidence: 99%

“…Several studies reported consistent reduction of blood loss (e.g., [ 13 , 16 , 33 ]), while others note the reduction as not significant [ 30 , 31 ]. The accuracy of acetabulum fracture reduction is reported to be similar or slightly better in cases using 3D-printed models for plate contouring (e.g., [ 20 , 30 , 31 ]).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery

Marinescu

Popescu

Lăptoiu

2020

JCM

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This paper is a systematic review of the literature on 3D-printed anatomical replicas used as templates for precontouring the fixation plates in orthopedic surgery. Embase, PubMed, Cochrane, Scopus and Springer databases were consulted for information on design study, fracture anatomical location, number of patients, surgical technique, virtual modeling approach and 3D printing process. The initial search provided a total of 496 records. After removing the duplicates, the title and abstract screening, and applying exclusion criteria and citations searching, 30 papers were declared eligible and included in the final synthesis. Seven studies were identified as focusing on retrospective non-randomized series of clinical cases, while two papers presented randomized case control studies. Two main approaches were highlighted in developing 3D-printed anatomical models for precontouring fixation plates: (a.) medical reconstruction, virtual planning and fracture reduction followed by 3D printing the model; (b.) medical reconstruction followed by 3D printing the model of the mirrored uninjured side. Revised studies reported advantages such as surgical time and blood loss reduction, while the reduction quality is similar with that of the conventional surgery. During the last couple of years there was an increase in the number of studies focused on precontouring orthopedic plates using 3D printing technology. Three-dimensionally-printed templates for plate precontouring were mostly used for acetabular fractures. Knowledge on medical virtual modeling and reconstruction is mandatory.

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Instrument-tissue Interaction Quintuple Detection in Surgery Videos

Lin

Hao

et al. 2022

Lecture Notes in Computer Science

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Instrument-tissue interaction detection task, which helps understand surgical activities, is vital for constructing computer-assisted surgery systems but with many challenges. Firstly, most models represent instrument-tissue interaction in a coarse-grained way which only focuses on classification and lacks the ability to automatically detect instruments and tissues. Secondly, existing works do not fully consider relations between intraand inter-frame of instruments and tissues. In the paper, we propose to represent instrument-tissue interaction as ⟨instrument class, instrument bounding box, tissue class, tissue bounding box, action class⟩ quintuple and present an Instrument-Tissue Interaction Detection Network (ITID-Net) to detect the quintuple for surgery videos understanding. Specifically, we propose a Snippet Consecutive Feature (SCF) Layer to enhance features by modeling relationships of proposals in the current frame using global context information in the video snippet. We also propose a Spatial Corresponding Attention (SCA) Layer to incorporate features of proposals between adjacent frames through spatial encoding. To reason relationships between instruments and tissues, a Temporal Graph (TG) Layer is proposed with intra-frame connections to exploit relationships between instruments and tissues in the same frame and inter-frame connections to model the temporal information for the same instance. For evaluation, we build a cataract surgery video (PhacoQ) dataset and a cholecystectomy surgery video (CholecQ) dataset. Experimental results demonstrate the promising performance of our model, which outperforms other state-of-the-art models on both datasets.

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Application of computer-assisted virtual surgical procedures and three-dimensional printing of patient-specific pre-contoured plates in bicolumnar acetabular fracture fixation

Cited by 35 publications

References 19 publications

Biomechanical Comparison of Different Fixation Techniques for Typical Acetabular Fractures in the Elderly

Biomechanical Comparison of Different Fixation Techniques for Typical Acetabular Fractures in the Elderly

A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery

Instrument-tissue Interaction Quintuple Detection in Surgery Videos

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