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

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.

Clinical applications and prospects of 3D printing guide templates in orthopaedics

“… 2020 Tu Q et al. [ 163 ] Hip Int 12 Femoral osteotomy guiding template for DDH It provided a new personalized surgical plan for the precise positioning and orientation of acetabular reconstruction and femoral osteotomy. 2020 Gu F et al.…”

“…Tu et al. [ 163 ] evaluated 12 patients with 3D-printing individualized guiding templates in total hip arthroplasty (THA) for the treatment of DDH. The 3D printing personalized guidance template met the surgeon's specific requirements for the treatment of Crowe IV DDH, and the patient recovered well after surgery with no loosening of the hip joint, providing a new personalized surgical plan for the precise positioning and orientation of acetabular reconstruction and femoral osteotomy.…”

Effect of 3D Printing Technology in Proximal Femoral Osteotomy in Children with Developmental Dysplasia of the Hip

“…Therefore, a more accurate preoperative measurement method is needed clinically to assist in accurate and rapid completion of proximal femoral osteotomy in order to obtain better surgical efficacy. 3D printing is a new technology developed in the 21st century and has been rapidly applied in the field of medicine [15][16][17]. 3D printing technology deals with femoral imaging data by software and makes equal large physical models with the help of a 3D printer.…”

Clinical Applications of “In-Hospital” 3D Printing in Hip Surgery: A Systematic Narrative Review

“…3.4.6. Patient-Specific Instrumentation for Femoral Neck Osteotomy [49,51] Following the hip segmentation, the guide for the femoral neck osteotomy (above the tip of the lesser trochanter and at an angle of 45 degrees to the femoral shaft) is determined based on preoperative three-dimensional planning, including coronal (XZ) and sagittal (YZ) alignment of the femoral component.…”

“…Femoral neck osteotomy in THA [49][50][51] Review [49] Japan Retr. comparative [50] 72 (40) China Case series [51] 30 (30) Switzerland Femoral diaphyseal osteotomy in Crowe IV DDH [52] Case series 12 (12) China CAM osteoplasty [61] Case report 1 (1) India Osteosynthesis of intracapsular neck of femur fractures [63] Prosp. comparative 40 ( 20) China Trephination of specific trabeculae from femoral heads [69] Prosp.…”