Abstract
3D imaging tools significantly expand the ability to assess the bone tissue condition, both in terms of its qualitative properties and in terms of accurate determination of bone defect geometry and volume.The purpose of the study was to determine the 3D imaging potential for the preoperative planning and correction of surgical tactics in hip arthroplasty.Materials and Methods. A retrospective analysis of the preoperative planning of 110 primary and revision hip arthroplasties with 3D imaging was performed. The following specialized software were employed: RadiAnt DICOM Viewer file converter — for 3D models production; 3D/CAD designers — for volumetric models processing and correction; InVesalius 3.0 program — for bone density evaluation by the Hounsfield scale; K-Pacs — for viewing MSCT and X-ray images. All patients underwent pelvic bones radiography in the front and anterior-lateral planes. Post-traumatic acetabular deformity was described in accordance with the X-ray picture in each individual clinical case. For revision arthroplasty, the acetabular defect was determined according to the W.G. Paprosky classification. In 36 patients (32.7%), the acetabulum defect was the result of trauma. In 74 patients (67.3%), the cause of surgery was endoprosthesis components loosening.Results. In 80% of cases (88 patients), the analysis of the 3D model did not change the surgical tactics determined in the preoperative planning using pelvic radiographs; in 20% of cases (22 patients), the use of 3D imaging revealed new circumstances and changed the surgical tactics.Conclusion. In standard cases, it is possible to use the traditional preoperative planning using radiographs in several planes. In primary hip arthroplasty in the patients with post-traumatic deformity, including a false joint of acetabulum bottom or 2 to 3 degree osteopenia, it is advisable to perform 3D imaging. In the case of revision arthroplasty, 3D visualization is indicated in acetabulum Paprosky IIIA, IIIB defects with pelvic discontinuity.
Highlights
Ревизионное эндопротезирование тазобед ренного сустава требует значительных материальных ресурсов, высокой квалификации оперирующего хирурга, а также точного выбора операционной тактики [5, 6, 7]
В результате более детального предоперационного планирования с использованием объемной визуализации из 110 исследованных клинических случаев в 22 (20%) тактика оперативного лечения была скорректирована
(Med.), Researcher, Department of Arthroplasty and Arthroscopy, Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics, Novosibirsk, Russian Federation
Summary
Цель исследования — определить возможности объемной визуализации в предоперационном планировании эндопротезирования тазобедренного сустава для коррекции хирургической тактики. Базлов В.А., Мамуладзе Т.З., Голенков О.И., Ефименко М.В., Пронских А.А., Харитонов К.Н., Панченко А.А., Павлов В.В. Выбор хирургической тактики при первичном и ревизионном эндопротезировании тазобедренного сустава с использованием инструментов объемной визуализации. A retrospective analysis of the preoperative planning of 110 primary and revision hip arthroplasties with 3D imaging was performed. In primary hip arthroplasty in the patients with post-traumatic deformity, including a false joint of acetabulum bottom or 2 to 3 degree osteopenia, it is advisable to perform 3D imaging. Инструменты объемной визуализации значительно расширяют возможности оценки костной ткани травматология и ортопедия россии / Traumatology and orthopedics of Russia. Цель исследования — продемонстрировать возможности объемной визуализации при предоперационном планировании эндопротезирования тазобедренного сустава для выбора хирургической тактики
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