scholarly journals 3D Printed Personalized Guide Plate in the Femoral Head Core Decompression

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Liangliang Cheng ◽  
Xing Qiu ◽  
Lei Yang ◽  
Chi Xiao ◽  
Baoyi Liu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Three Dimensional ◽  
Core Decompression ◽  
Operation Time ◽  
Drill Hole ◽  
Needle Insertion ◽  
Pathological Examination ◽  
Anatomic Structure ◽  
Guide Plate ◽  
3D Printed

Objective. To investigate the feasibility of using 3D printed personalized guide plates in core decompression procedures for the treatment of osteonecrosis of the femoral head (ONFH). Methods. The clinical data of 8 patients undergoing femoral head core decompression from January to December 2019 were analyzed retrospectively. Three-dimensional (3D) images of the patients were reconstructed from the CT scan data taken preoperatively. From the data obtained, puncture position, drill hole, and depth were evaluated, and individualized 3D puncture guide plates were designed using Mimics 21.0 software. During the operation, the needle went through the hole of the guide plate, the depth of the drill was controlled, and the obtained bone tissues were sent for pathological evaluation. Intraoperative X-ray and postoperative pathological results were used to evaluate the success of the puncture. Results. The individualized guide plates used for core compression on the 8 patients were well fitted with the anatomic structure of the puncture site, and the direction and depth of the needle insertion were consistent with the preoperative design. The operation time was about 15-22 mins. The position of the decompression tunnel was the same as the designed plate. The postoperative pathology showed necrotic bone tissue. There were no postoperative complications such as infection, bleeding, and fracture. Conclusion. The 3D printed individualized guide plate can simplify core decompression and would make this procedure more accurate, safe, and quick, in addition to obtaining necrotic tissues for pathological examination.

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Three-dimensional finite element analysis of silk protein rod implantation after core decompression for osteonecrosis of the femoral head

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Liangta Huang ◽  
Feiyan Chen ◽  
Siqun Wang ◽  
Yibing Wei ◽  
Gangyong Huang ◽  
...  
Keyword(s):  
Finite Element ◽  
Femoral Head ◽  
Surface Stress ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Core Decompression ◽  
Silk Protein ◽  
Head Weight ◽  
Dimensional Finite Element ◽  
Three Dimensional Finite Element

Abstract Background Several methods are available for the treatment of early-stage osteonecrosis of the femoral head. Core decompression with implantation is a widely-used treatment. However, no single implant is recognized as the most effective way to prevent disease progression. Silk has high strength and resiliency. This study explored the possibility of a strong and resilient silk protein biomaterial as a new alternative implant. Methods We investigated the biomechanical properties of the silk protein material by regular compression, torsion, and three-point bending tests. We established three-dimensional finite element models of different degrees of femoral head osteonecrosis following simple core decompression, fibula implantation, porous tantalum rod implantation, and silk protein rod implantation. Finally, we compared the differences in displacement and surface stress under load at the femoral head weight-bearing areas between these models. Results The elastic modulus and shear modulus of the silk protein material was 0.49GPa and 0.66GPa, respectively. Three-dimensional finite element analyses demonstrated less displacement and surface stress at the femoral head weight-bearing areas following silk protein rod implantation compared to simple core decompression (p < 0.05), regardless of the extent of osteonecrosis. No differences were noted in the surface deformation or surface stress of the femoral head weight-bearing areas following silk protein rod, fibula or tantalum rod implantation (p > 0.05). Conclusions When compared with simple core decompression, silk protein rod implantation demonstrated less displacement and surface stress at the femoral head weight-bearing area, but more than fibula or tantalum rod implantation. Similar effects on the surface stress of the femoral head between the silk rod, fibula and tantalum rod implantations, combined with additional modifiable properties support the use of silk protein as a suitable biomaterial in osteonecrosis surgery.

scholarly journals Clinical application of multiple 3D-printed guide plates for precise reduction and fixation of comminuted patellar fractures

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097208
Author(s):  
Zhi-Sheng Long ◽  
Fei-Peng Gong ◽  
Xie-Ping Dong ◽  
Jing-Tang Li
Keyword(s):  
Knee Joint ◽  
Articular Surface ◽  
Good Condition ◽  
Three Dimensional ◽  
Operation Time ◽  
Left Knee ◽  
Preoperative Imaging ◽  
Anatomical Landmarks ◽  
3D Printed ◽  
Patellar Fractures

Because of the lack of anatomical landmarks during reduction of multiple articular surfaces and fragments in comminuted patellar fractures, loss of bone fragments or aggravation of soft tissue and ligament injuries readily occurs. In the present case, we used multiple three-dimensional (3D)-printed guide plates to reduce and fix a comminuted patellar fracture. A 22-year-old man was hospitalized for 2 days because of left knee joint pain and limited movement caused by a traffic accident. Preoperative imaging revealed a comminuted fracture of the left patella (type 34-C3 according to the AO/OTA classification). Throughout a 2-year follow-up, the patient remained in generally good condition with no significant limitation of his left knee joint activity. Application of multiple 3D-printed guide plates is a safe and effective auxiliary technique for the treatment of comminuted patellar fractures. This novel technique can shorten the operation time, reduce the number of fluoroscopic procedures, and ensure fracture healing and recovery of knee joint function through reliable reduction of the articular surface.

scholarly journals Application of 3D printed osteotomy guide plate-assisted total knee arthroplasty in treatment of valgus knee deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhimin Shen ◽  
Hong Wang ◽  
Yiqiang Duan ◽  
Jian Wang ◽  
Fengyan Wang
Keyword(s):  
Total Knee Arthroplasty ◽  
Treatment Group ◽  
Knee Arthroplasty ◽  
Combined Treatment ◽  
Operation Time ◽  
Valgus Knee ◽  
Guide Plate ◽  
Knee Deformity ◽  
3D Printed ◽  
Total Knee

Abstract Introduction To analyze the application of 3D printed osteotomy guide plate-assisted total knee arthroplasty (TKA) for valgus knee deformity. Methods The clinical data of 20 patients with valgus knee deformity admitted to our hospital from April 2012 to April 2017 were collected and analyzed. According to the treatment method, these patients were divided into two groups: 3D printed osteotomy guide plate-assisted TKA (combined treatment group, n = 10) and TKA (treatment group, n = 10). The operation time, intraoperative bleeding volume, postoperative mean femorotibial angle (MFTA), and Knee Society Score (KSS) of the two groups were statistically analyzed. Results Compared with the treatment group, the operation time was significantly shorter (P < 0.05), the intraoperative blood loss and postoperative MFTA were significantly decreased (P < 0.05), and the clinical and functional scores were significantly increased (P < 0.05) in the combined treatment group. Conclusion 3D printed osteotomy guide plate-assisted TKA for valgus knee deformity is more effective than TKA alone.

scholarly journals Three‐dimensional‐printed customized prosthesis for pubic defect: clinical outcomes in 5 cases at a mean follow‐up of 24 months

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuqi Zhang ◽  
Li Min ◽  
Minxun Lu ◽  
Jie Wang ◽  
Yitian Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Clinical Outcomes ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Operation Time ◽  
Pubic Bone ◽  
Type Iii ◽  
3D Printed ◽  
The Mean

Abstract Background Pubic defects resulting from type III hemipelvectomy are commonly not reconstructed due to the need to preserve the weight-bearing axis. However, the opening of the anterior pelvic ring will inevitably lead to increased pelvic instability. To improve long-term pelvic stability, three-dimensional (3D)-printed customized prostheses were designed to reconstruct pubic defects. This study presents and evaluates the short-term clinical outcomes and complications from the use of this construct. Methods Five patients who underwent type III hemipelvectomy and 3D-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analysed. Operation time and blood loss during the operation were recorded. Local and functional recovery was assessed. Prosthetic position and osseointegration were evaluated. Oncology results and complications were recorded. Results The prostheses consisted of three with stems and two without. The mean follow-up time was 23.6 months. At the last follow-up, all five patients were alive with no evidence of disease. No deep infections or local recurrence had occurred. The mean blood loss and mean intraoperative time were 1680 ml and 294 min, respectively. The mean functional MSTS score at the final follow-up was 29.8. Fretting wear around the prosthetic stem was found in 3 patients, while bone wear on the normal-side pubis was found in 2 patients. Osseointegration was observed in all patients. Conclusions 3D-printed customized prostheses for reconstructing pubic bone defects after type III hemipelvectomy showed acceptable early outcomes. The good outcomes were inseparable from the precision prosthesis design, strict surgical procedures, and sensible postoperative management.

scholarly journals The effect of robot-navigation-assisted core decompression on early stage osteonecrosis of the femoral head

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Benjun Bi ◽  
Shudong Zhang ◽  
Yuchi Zhao
Keyword(s):  
Femoral Head ◽  
Radiation Exposure ◽  
Early Stage ◽  
Core Decompression ◽  
Operation Time ◽  
Visual Analog Scale Score ◽  
Harris Hip Score ◽  
Decompression Surgery ◽  
Robot Assisted ◽  
Intraoperative Radiation

Abstract Background The aim of the current paper is to evaluate the effects of robot-navigation-assisted core decompression compared with conventional core decompression surgery for early-stage osteonecrosis of the femoral head. Methods Twenty patients with a total of 36 hips who were diagnosed with Association Research Circulation Osseous stage 2 avascular necrosis of the femoral head and who received core decompression with or without robotic assistance were reviewed. The Harris hip score and visual analog scale score were used to assess clinical function. Intraoperative radiation exposure and operation time were used to evaluate the effectiveness of the robot-assisted system. Results At a mean follow-up of 26.4 months (24–36 months), the Harris hip score, visual analog scale score, and survival rate of the patients were similar between the conventional and robot-assisted groups. The guidewire insertion time, number of guidewire attempts, and radiation exposure during guidewire insertion were all significantly lower in the robot-assisted group than in the conventional group. Conclusions Robot-assisted core decompression of the femoral head is as safe and effective as a conventional core decompression surgery. It can reduce operation time and decrease intraoperative radiation exposure.

scholarly journals Analysis of the long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head

2018 ◽  
Vol 34 ◽  
pp. 43-46 ◽  
Author(s):  
Pengfei Zhao ◽  
Jing Hao
Keyword(s):  
Postoperative Pain ◽  
Femoral Head ◽  
Bone Grafting ◽  
Calcium Sulfate ◽  
Core Decompression ◽  
Operation Time ◽  
Intraoperative Blood Loss ◽  
Term Efficacy ◽  
Pain Scores

Objective: to investigate the safety and long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head. Method: a total of 76 patients with non-traumatic osteonecrosis of the femoral head were admitted to our hospital from February 2012 to November 2014 and included in the study. All the patients were treated by core decompression with synthetic calcium-sulfate bone grafting. After treatment, the patients were followed-up for 12 months. The operation time, intraoperative blood loss, and perioperative complications were also recorded intraoperatively to evaluate the clinical efficacy and safety. The preoperative and postoperative pain scores measured by visual analogy score (VAS) were also recorded and compared. Results: all of the 76 patients were successfully operated and included in the study. The mean operation time was 34.6±14.2 min, and the intraoperative blood loss was 23.6±8.9 mL. The patients hip functions were assessed on the basis of the Harris hip score, 3 and 12 months after operation. The excellent rates 3 and 12 months after operation were significantly higher than those before operation (P<0.05). The imaging stabilities of the hip joints 3 and 12 months after operation were significantly higher than those before operation (P<0.05). The patient postoperative pain scores (VAS score) gradually decreased. The VAS scores 12 months after operation were significantly lower than those before operation (P<0.05). Conclusion: the long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head is good and accompanied with significantly improved postoperative joint functions.

scholarly journals Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

2020 ◽  
Author(s):  
YQ Zhang ◽  
Li Min ◽  
Minxun Lu ◽  
J Wang ◽  
Yitian Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Clinical Outcomes ◽  
Three Dimensional ◽  
Operation Time ◽  
Musculoskeletal Tumor Society ◽  
Type Iii ◽  
Msts Score ◽  
3D Printed ◽  
The Mean

Abstract Background This study is to present and evaluate the short-term clinical outcomes and associated complications of 3D-printed customized prostheses for pubic defect reconstruction. Methods 5 patients receiving type III hemipelvectomy and three-dimensional-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analyzed in this study. The operation time and blood loss during operation were recorded. The local and functional recovery was assessed by the physical examination and Musculoskeletal Tumor Society (MSTS) score. The prosthetic position and Osseointegration were evaluated by imaging examination. Oncology result and complications were recorded. Functional comparisons with MSTS score of patients grouped by resection extent were done. Results Of 5 cases, the prosthese consist of the type with stem (3, 60%) and the type without stem (2, 40%). Mean follow-up period was 17.6 months (range, 10–26 months). All 5 patients were alive with no evidence of disease. No deep infection and local recurrence occurred. The mean blood loss and mean intraoperative time was 1680 ml (range, 300 to 3700 ml) and 294 min (range, 180 to 430 min). The mean functional MSTS score at the final follow-up was 29.8 (range, 29–31). 1 male patient complained erectile dysfunction. Fretting wear around prosthetic stem was found in 3 patients while bone wear on the normal side pubis was found in 2 patients. Osseointegration was observed in all patients. Conclusion 3D-printed customized prostheses could be a feasible option to reconstruct the pubic bone defects after type III hemipelvectomy. The good outcomes are inseparable from precision prostheses design and strict surgical procedures.

Drilling and plombage (core decompression) of a femoral head avascular necrosis

2010 ◽  
Vol 19 (01) ◽  
pp. 36-39 ◽  
Author(s):  
P. Chládek ◽  
V. Havlas ◽  
T. Trc
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Core Decompression ◽  
Effective Treatment Option ◽  
Simple Method ◽  
X Ray ◽  
Large Femoral Head ◽  
Press Fit ◽  
Round Shape ◽  
Late Stages

SummaryThe treatment of femoral head necrosis of adults is still rather problematic. Conservative treatment has been reported relatively unsuccessful and surgical treatment does not show convincing results either. The most effective seems to be a surgical treatment in early stages of the disease, however, the diagnosis still remains relatively complicated. For the late stages (2B and above) the most effective treatment option is represented by core decompression and vascular grafting. However, drilling and plombage (especially when using press-fit technique) seems to be successful, although not excellent. The authors describe their own method of drilling and plombage of the necrotic zone of the femoral head in 41 patients with X-ray detected necrotic changes of the femoral head. The pain measured by VAS was seen to decrease after surgery in all patients significantly. The Jacobs score was also observed to have increased (from fair to good outcome). We have not observed any large femoral head collapse after surgery, moreover, in some cases an improvement of the round shape of the femoral head was seen. It is important to mention that in all cases femoral heads with existing necrotic changes (flattening or collapse) were treated. Although the clinical improvement after surgery was not significantly high, the method we describe is a safe and simple method of diminishing pain in attempt to prepare the femoral head for further treatment in a future, without significant restriction of the indication due to necrosis (osteochondroplasty, resurfacing, THR).

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