Abstract
Introduction: Surgical planning for complex total hip arthroplasty (THA) often presents a challenge. Definitive plans can be difficult to decide upon, requiring unnecessary equipment to be ordered and a long theatre list booked. We present a pilot study utilising patient-specific 3D printed models as a method of streamlining the pre-operative planning process.Methods: Complex patients presenting for THA were referred to the research team. Patient-specific 3D models were created from routine Computed Tomography (CT) imaging. Simulated surgery was performed to guide prosthesis selection, sizing and the surgical plan.Results: Seven patients were referred for this pilot study, presenting with complex conditions with atypical anatomy. Surgical plans provided by the 3D models were more detailed and accurate when compared to 2D CT and X ray imaging. Streamlined equipment selection was of great benefit, with augments avoided post simulation in three cases. The ability to tackle complex surgical problems outside of the operating theatre also flagged potential complications, while also providing teaching opportunities in a low risk environment.Conclusion: This study demonstrated that 3D printed models can improve the surgical plan and streamline operative logistics. Further studies investigating the optimal 3D printing material and workflow, along with cost-benefit analyses are required before this process is ready for routine use.
Highlights
Surgical planning for complex total hip arthroplasty (THA) often presents a challenge
Simulation with patient-specific 3D printed models conferred superior clinical, logistical and educational outcomes compared to Computed tomography (CT) and X rays (XR)
Our pilot study reports encouraging findings indicating that simulation with patient-specific models narrows the definitive surgical plan, streamlines prosthesis selection and predicts potential complications prior to complex THA
Summary
Surgical planning for complex total hip arthroplasty (THA) often presents a challenge. We present a pilot study utilising patient-specific 3D printed models as a method of streamlining the pre-operative planning process. The main indications for the procedure are pathologies which alter the biomechanics of the hip joint: most commonly osteoarthritis, fracture, and tumour infiltration. These conditions displace the centre of rotation of the joint via bony destruction. THA aims to correct these defects by restoring the centre of rotation, maintaining alignment and offset of the joint, preserving adequate bone stock and ensuring stability of the hip joint through either a cemented or uncemented prosthesis [2]. In patients with atypical anatomy, this can be very challenging to achieve
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