Tailor-made Surgical Guide Reduces Incidence of Outliers of Cup Placement

Hananouchi, Takehito; Saito, Masanobu; Koyama, Tsuyoshi; Sugano, Nobuhiko; Yoshikawa, Hideki

doi:10.1007/s11999-009-0994-4

Cited by 42 publications

(43 citation statements)

References 26 publications

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“…There were no significant differences based on surgeon (p = 0.20 for inclination, p = 0.87 for version). By comparison, based on the review of historical case controls in vivo (Table 3, extended from a previous review), 13 the average inclination errors ranged from 3.7°to 6.3°for the conventional technique, 1.6°to 4.2°f or CAS, and 1.3°to 3.2°for patient-specific guides; the average version errors ranged from 5.1°to 13.0°for the conventional technique, 0.2°to 5.3°for CAS, and 1.0°t o 3.7°for patient-specific guides ( Table 3). The percentage of outliers greater than 10°ranged from 20% to 83% for conventional techniques, 0% to 25% for CAS, and 0% for patient-specific techniques.…”

Section: Resultsmentioning

confidence: 99%

Accuracy of an adjustable patient-specific guide for acetabular alignment in hip replacement surgery (Optihip)

Shandiz

Mackenzie

Hunt

et al. 2014

Proc Inst Mech Eng H

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Implant malalignment in hip arthroplasty increases the risk of revision surgery due to problems such as hip instability, wear, and impingement. Traditional instrumentation lacks accuracy and does not individualize the goal. Computer-assisted surgery (CAS) and patient-specific solutions improve accuracy but add considerably to the cost, amongst other drawbacks. We developed an adjustable mechanical device, called Optihip, which is set to a patient-specific goal preoperatively and is independent of pelvis position intraoperatively. The purpose of the present study was to evaluate Optihip's accuracy ex vivo. Acetabular components were implanted into six cadaveric specimens, 12 hips, by two surgeons, with the device individually adjusted according to preoperative templating on computed tomography (CT) images relative to defined acetabular rim landmarks; options also exist for templating on single or biplanar X-rays. Intraoperatively, the device was positioned on the corresponding anatomical landmarks allowing the insertion of a guide pin, which then defined the desired orientation of the acetabular cup during impaction. Mean absolute difference between the preoperatively planned cup alignment and final acetabular cup orientation, measured from postoperative CT images, was 2.5±1.2° for inclination and 2.5±2.2° for version with maximum values of 4.7° and 6.8°, respectively. Compared with previous in vivo reports, Optihip guided the acetabular cup orientation more accurately than conventional hip arthroplasty, and comparably to CAS or patient-specific systems, while fitting into the normal surgical workflow. Although clinical testing is required to confirm these experimental results, the positive ex vivo accuracy suggests good potential for improving revision rates and patient functional outcome.

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Section: Resultsmentioning

confidence: 99%

Accuracy of an adjustable patient-specific guide for acetabular alignment in hip replacement surgery (Optihip)

Shandiz

Mackenzie

Hunt

et al. 2014

Proc Inst Mech Eng H

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“…Reverse modeling and RP technologies are widely used both at home and abroad to produce 3D-printed surgical navigation templates10111213. However, there have been no reports of their use in the treatment of older children with DDH.…”

Section: Discussionmentioning

confidence: 99%

3D-printed navigation template in proximal femoral osteotomy for older children with developmental dysplasia of the hip

Zheng

Yao

et al. 2017

Sci Rep

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To explore the feasibility of 3D-printed navigation template in proximal femoral varus rotation and shortening osteotomy for older children with developmental dysplasia of the hip (DDH). Between June 2014 and May 2015, navigation templates were designed and used for 12 DDH patients. Surgical information and outcomes were compared to 13 patients undergoing the same surgery but without navigation template. In template-guided patient group, operation time (21.08 min vs. 46.92 min), number of X-ray exposures (3.92 vs. 6.69), and occurrence of femoral epiphysis damage (0 vs. 0.92) were significantly decreased (P < 0.05). Furthermore, after 12–18 months follow-up, 66.7% and 16.7% of the hips in template-guided group were rated as excellent or good, respectively, according to the McKay criteria; 83.3% and 16.7% by using the Severin criteria respectively. By contrast, 46.2% and 23.1% of the hips in traditional operation group were classed as excellent or good, respectively, using the McKay criteria; 46.2% and 30.8% by using the Severin criteria respectively. The template-guided group achieved a better outcome; however, there was no significant difference. Application of the navigation template for older DDH children can reduce the operation time, radiation exposure, and epiphysis damage, which also simplifies surgery and improves precision.

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“…Total knee arthroplasty [11][12][13][14][15][16][17][18] , total hip arthroplasty [19][20][21] , hip resurfacing 22 , pelvic and acetabular procedures [23][24][25] , and spinal deformities 26,27 have all utilized patient-specific instrument technology with varying degrees of success. Recently, patientspecific instrumentation was found to improve glenoid component placement in both the version and inclination planes when compared with standard two-dimensional surgical planning 28,29 .…”

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confidence: 99%