Complex Revision Arthroplasty Planning with Telemedicine Expert Advice

Abstract

Relevance. An increase in the number of revisions is an inevitable consequence of the growth of primary arthroplasty number. The imperfection of implants and the lag in patient’s seeking medical help significantly increase the number of complex revisions. Extensive bone defects after removal of an unstable implant urge us to think about the better methods of these defects compensation and implants fixation. The purpose — was to assess the modern telemedicine opportunities for improving the preoperative planning of the complex revision arthroplasties. Materials and Methods. The study comprised 13 patients undergone revisions for implant instability in a regional orthopedic department using telemedicine differed advices including 11 hip and 2 knee arthroplasties. All patients had extensive bone defects. Results. In 12 cases, the surgeries were performed according to the recommendations from the expers of the Vreden National Medical Research Center of Traumatology and Orthopedics, St. Petersburg, Russian Federation. In one case, an individual system had been proposed as the main choice, but the preoperative plan was changed in favor of standard revision components. The short-term results of the surgeries were assessed as satisfactory. Conclusion. The use of modern information technologies for preoperative planning makes it possible to more accurately determine the indications for choosing implants. In particularly difficult cases, it becomes necessary to use individual implants. The right final choice depends on high-quality preoperative planning and effective interaction among medical hospitals of various levels.