Novel 3D printed integral customized acetabular prosthesis for anatomical rotation center restoration in hip arthroplasty for developmental dysplasia of the hip crowe type III

Objective: To evaluate the feasibility and accuracy of three-dimensional (3D)-printed individualised guiding templates in total hip arthroplasty (THA) for the treatment of developmental dysplasia of the hip (DDH). Methods: 12 hips in 12 patients with Crowe type IV DDH were treated with THA. A 3D digital model of the pelvis and lower limbs was reconstructed using the computed tomography data of the patients. Preoperative surgical simulations were performed to determine the most suitable surgical planning, including femoral osteotomy and prosthesis placement. Based on the ideal surgical planning, individualised guiding templates were designed by software, manufactured using a 3D printer, and used in acetabulum reconstruction and femoral osteotomy during surgery. Results: 12 patients were followed up for an average of 72.42 months (range 38–135 months). During surgery, the guiding template for each case was matched to the bony markers of the acetabulum and proximal femur. Preoperative and follow-up Harris hip scores were 34.2 ± 3.7 and 85.2 ± 4.2; leg length discrepancy, 51.5 ± 6.5 mm and 10.2 ± 1.5 mm; and visual analogue scale scores, 6.2 ± 0.8 and 1.3 ± 0.3, respectively, with statistical difference. Shortened deformity and claudication of the affected limb were obviously improved after surgery. However, 1 patient had artificial hip dislocation 2 weeks after surgery, and another patient had sciatic nerve traction injury, both of whom recovered after physical treatment. Conclusions: Preoperative surgical simulation and 3D-printed individualised guiding templates can fulfil surgeon-specific requirements for the treatment of Crowe type IV DDH. Accurate THA can be achieved using 3D-printed individualised templates, which provide a new personalised surgical plan for the precise positioning and orientation of acetabular reconstruction and femoral osteotomy.

Download Full-text

3D printing navigation template used in total hip arthroplasty for developmental dysplasia of the hip

10.21203/rs.2.14570/v1 ◽

2019 ◽

Author(s):

liang yan ◽

Peng Wang ◽

Haibing Zhou

Keyword(s):

3D Printing ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Ischial Tuberosity ◽

Developmental Dysplasia ◽

Abduction Angle ◽

Total Hip ◽

Rotation Center ◽

Dysplasia Of The Hip ◽

Navigation Template

Abstract Background: It is difficult to locate the real acetabulum in the total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH), The goal of this study was to explore the application of 3D printing navigation template used in total hip arthroplasty (THA) for developmental dysplasia of the hip. Methods: Between February 2017 and May 2018, THAs were performed in 25 patients with DDH, all patients (12 cases undergoing THA with 3D printing navigation template, 13 cases undergoing traditional THA) were followed-up for an average of 14.6 months. Surgical information and outcomes treated with different approaches were compared. Results: The 3D printing group provided shorter operation time, lower intra- and post-operative hemorrhage and higher post-operative Harris scores. postoperative infection and prosthetic loosening were 0 in two groups. There were no significant differences in anteversion angle, abduction angle and the distance from rotation center to the ischial tuberosity connection between ipsilateral and contralateral sides in 3D printing group. The abduction angle and the distance from rotation center to the ischial tuberosity connection were significantly different between the two sides in the traditional group. Conclusion: The finding suggests that 3D printing navigation template used in total hip arthroplasty is an individualized, accurate technology. Keywords: 3D printing technology, total hip arthroplasty, developmental dysplasia of the hip, navigation template

Download Full-text

Restoring Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology: A Pilot Study

Orthopaedic Surgery ◽

10.1111/os.13183 ◽

2021 ◽

Author(s):

Heng Zhang ◽

Jian‐zhong Guan ◽

Zheng Zhang ◽

Xiao‐tian Chen ◽

Xiao‐dong Ma ◽

...

Keyword(s):

Pilot Study ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Three Dimensional ◽

Developmental Dysplasia ◽

Three Dimensional Printing ◽

Total Hip ◽

Rotation Center ◽

Dimensional Printing ◽

Dysplasia Of The Hip

Download Full-text

How to restore rotation center in total hip arthroplasty for developmental dysplasia of the hip by recognizing the pathomorphology of acetabulum and Harris fossa?

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1373-9 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Heng Zhang ◽

Jiansheng Zhou ◽

Jianzhong Guan ◽

Hai Ding ◽

Zhiyan Wang ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Developmental Dysplasia ◽

Horizontal Distance ◽

Total Hip ◽

Rotation Center ◽

Pelvic Radiographs ◽

End Stage ◽

Hip Rotation ◽

Dysplasia Of The Hip

Abstract Purpose To restore rotation center exactly in total hip arthroplasty (THA) is technically challenging for patients with end-stage osteoarthritis due to developmental dysplasia of the hip (DDH). The technical difficulty is attributable to the complex acetabular changes. In this study, we investigated the pathomorphology of acetabulum and Harris fossa of Crowe types I to IV and discussed the method of restoring rotation center of the hip. Methods This study retrospectively reviewed 56 patients (59 hips) who underwent cementless THA due to end-stage osteoarthritis of DDH. The pathomorphology of acetabulum and Harris fossa was observed during operations. Using the preoperative and postoperative pelvic radiographs, the vertical and the horizontal distances of hip rotation center were measured in order to evaluate the effects of restoring rotation center of the hip. Results Adult DDH acetabulum could be classified into four basic pathological types which include the shallow cup shape, the dish shape, the shell shape, and the triangular shape. Adult DDH Harris fossa could be classified into four pathological types, including the crack shape, the closed shape, the triangle shape, and the shallow shape, in accordance with the osteophyte coverage. The vertical and horizontal distances of hip rotation center on the pelvic radiographs before and after operations were as follows: the preoperative vertical distance of hip rotation center was (39.96 ± 5.65) mm, and the postoperative one was (13.83 ± 2.66) mm; the preoperative horizontal distance of hip rotation center was (42.15 ± 6.42) mm, and the postoperative one was (28.12 ± 4.56) mm. Conclusions The acetabulum and Harris fossa can display different pathological types on account of different degrees of dislocation and osteophyte hyperplasia in the end-stage osteoarthritis of adult DDH. The hip rotation center can be accurately restored by locating the acetabular center with Harris fossa and acetabular notch as the marks.

Download Full-text