Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

Savov, Peter; Budde, Stefan; Tsamassiotis, Spiros; Klintschar, Michael; Ettinger, Max

doi:10.1007/s00402-020-03394-7

Cited by 10 publications

(7 citation statements)

References 34 publications

(58 reference statements)

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“…In the 30 cases of CT data we studied, there was no bilateral difference in sagittal plane and anteversion. The application of CT is a preoperative plan, which can effectively understand the three-dimensional structure of the femur [ 16 , 20 ]. It is very useful for patients with three-dimensional structural deformities of the hip, such as DDH, or patients with a history of proximal femoral osteotomy.…”

Section: Discussionmentioning

confidence: 99%

Morphological consistency of bilateral hip joints in adults based on the X-ray and CT data

et al. 2021

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Purpose The application of the anatomical parameters of the contralateral hip joint to guide the preoperative template of the affected side relies on the bilateral hip symmetry. We investigated the bilateral hip symmetry and range of anatomical variations by measurement and comparison of bilateral hip anatomical parameters. Methods This study included 224 patients (448 hips) who were diagnosed with osteoarthritis (OA) and avascular necrosis (AVN) of the femur head, and underwent bilateral primary total hip arthroplasty (THA) in our hospital from January 2012 to August 2020. Imaging data included 224 patients X-ray and 30 CT data at the end of the cohort. Anatomical parameters, including the acetabular abduction angle and trochanteric height, were measured using the Noble method. Postoperative measurements included stem size, difference of leg length and offset. Results Except for the isthmus width, there were no significant differences in the anatomical morphology of the hip joint. Among the demographic factors, there was a correlation between body weight and NSA. Among various anatomical parameters, a correlation was present between medullary cavity widths of T + 20, T, and T − 20. The difference in the use of stem size is not due to the morphological difference of bilateral medullary cavity, but due to the different of 1- or 2-stage surgery. Conclusion Bilateral symmetry was present among the patients with normal morphology of the hip medullary cavity, theoretically confirming the feasibility of structural reconstruction of the hip joint using the hip joint on the uninjured side. Additionally, the difference in the morphology of the hip medullary cavity is not present in a single plane but is synergistically affected by multiple adjacent planes.

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Section: Discussionmentioning

confidence: 99%

Morphological consistency of bilateral hip joints in adults based on the X-ray and CT data

et al. 2021

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“…The overall accuracy of 3D surgical planning in component size prediction has been proven satisfactory, with good inter-observer variability. 7 – 9 , 11 , 13 , 21 – 28 Prediction rates for femoral stem and acetabular cup sizes range between 34–100% and 41–100% respectively ( Table 3 ). Considering this, 3D pre-operative planning may lead to a reduction in intra-operative guesswork and allow an optimal implant inventory.…”

Section: Resultsmentioning

confidence: 99%

“…It allows 3D representation of the human anatomy and anatomical variables such as FO, COR and LLD to be accurately estimated. 13 , 21 , 23 , 29 Using 2D radiographs, anatomical features, such as FO, may be wrongly estimated by up to 13.7 mm 21 due to patients’ malposition. 29 …”

Section: Resultsmentioning

confidence: 99%

“… 7 – 9 Achieving these can eventually lead to a more accurate surgical procedure 9 with reduced implant inventory 7 resulting in a more cost-effective surgery. 8 It also enables the use of other computer-assisted techniques such as robotic-assisted surgeries, 10 navigation techniques 11 as well as the use of patient-specific instrumentation (PSI) 12 , 13 and implants. 14 …”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional pre-operative planning of primary hip arthroplasty: a systematic literature review

et al. 2020

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Three-dimensional (3D) pre-operative planning in total hip arthroplasty (THA) is being recognized as a useful tool in planning elective surgery, and as crucial to define the optimal component size, position and orientation. The aim of this study was to systematically review the existing literature for the use of 3D pre-operative planning in primary THA. A systematic literature search was performed using keywords, through PubMed, Scopus and Google Scholar, to retrieve all publications documenting the use of 3D planning in primary THA. We focussed on (1) the accuracy of implant sizing, restoration of hip biomechanics and component orientation; (2) the benefits and barriers of this tool; and (3) current gaps in literature and clinical practice. Clinical studies have highlighted the accuracy of 3D pre-operative planning in predicting the optimal component size and orientation in primary THAs. Component size planning accuracy ranged between 34–100% and 41–100% for the stem and cup respectively. The absolute, average difference between planned and achieved values of leg length, offset, centre of rotation, stem version, cup version, inclination and abduction were 1 mm, 1 mm, 2 mm, 4°, 7°, 0.5° and 4° respectively. Benefits include 3D representation of the human anatomy for precise sizing and surgical execution. Barriers include increased radiation dose, learning curve and cost. Long-term evidence investigating this technology is limited. Emphasis should be placed on understanding the health economics of an optimized implant inventory as well as long-term clinical outcomes. Cite this article: EFORT Open Rev 2020;5:845-855. DOI: 10.1302/2058-5241.5.200046

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“…The evolution of 3D planning has acted as a path to introducing innovative assisted technologies in hip surgery, particularly patient-specific instrumentation [ 24 ], but also navigation techniques and robotic-assisted surgeries [ 17 ]. Implant modifications, such as the introduction of modern ceramics and crosslinked polyethylene, have significantly improved arthroplasty bearing wear with encouraging preliminary results [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Preoperative Planning Software for Hip Resurfacing Arthroplasty

et al. 2023

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Three-dimensional planning of hip arthroplasty is associated with better visualisation of anatomical landmarks and enhanced mapping for preoperative implant sizing, which can lead to a decrease in surgical time and complications. Despite the advantages of hip resurfacing arthroplasty (HRA), it is considered a technically challenging procedure and associated with inaccurate implant placement. This study aimed to examine the validity, reliability, and usability of preoperative 3D Hip Planner software for HRA. Fifty random cases of various hip osteoarthritis severity were planned twice by two junior trainees using the 3D Hip Planner within a one-month interval. Outcome measures included femoral/cup implant size, stem-shaft angle, and cup inclination angle, and were assessed by comparing outcomes from 2D and 3D planning. An adapted unified theory of acceptance and use of technology (UTAUT) survey was used for software usability. Bland–Altman plots between 3D and 2D planning for stem-shaft and inclination angles showed mean differences of 0.7 and −0.6, respectively (r = 0.93, p < 0.001). Stem-shaft and inclination angles showed inter-rater reliability biases of around −2° and 3°, respectively. Chi-square and Pearson’s correlation for femoral implant size showed a significant association between the two assessors (r = 0.91, p < 0.001). The 3D test–retest coefficient of repeatability for stem-shaft and inclination angles were around ±2° and ±3°, respectively, with a strong significant association for femoral implant size (r = 0.98, p < 0.001). Survey analyses showed that 70–90% agreed that 3D planning improved expectancy in four domains. 3D hip planner appears to be valid and reliable in preoperative HRA and shows significant potential in optimising the quality and accuracy of surgical planning.

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Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

Cited by 10 publications

References 34 publications

Morphological consistency of bilateral hip joints in adults based on the X-ray and CT data

Morphological consistency of bilateral hip joints in adults based on the X-ray and CT data

Three-dimensional pre-operative planning of primary hip arthroplasty: a systematic literature review

Three-Dimensional Preoperative Planning Software for Hip Resurfacing Arthroplasty

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