scholarly journals 3D MODELLING AND PRINTING IN PRIMARY AND REVISION ARTHROPLASTY

2018 ◽  
Vol 25 (2) ◽  
pp. 21-29 ◽  
Author(s):  
N. V. Zagorodniy ◽  
G. A. Chragyan ◽  
O. A. Aleksanyan ◽  
S. V. Kagramanov ◽  
E. V. Polevoy
Keyword(s):  
Revision Arthroplasty ◽  
3D Modelling ◽  
Pelvic Bone ◽  
Type I ◽  
Biological Fixation ◽  
Surgical Interventions ◽  
Custom Made ◽  
Paprosky Classification ◽  
Acetabular Defects ◽  
Acetabular Components

Introduction. Acetabular arthroplasty in patients with the abnormal pelvic bone anatomy is a challenging task. In recent years the method of 3D modelling and printing of custom acetabular components is widely used at acetabular arthroplasty in patients with marked bone defects.Purpose of study: to evaluate the accuracy, convenience of the positioning and efficacy of the primary stabilization of custom acetabular components in patients with bone defects at primary and revision hip arthroplasty. Patients and methods. Eighteen surgical interventions using 3D modelling and printing, i.e. 12 for hip instability, 6 — for posttraumatic coxarthrosis were performed. The study included 9 women and 9 men with mean age 60.9±15.8 years. By Paprosky classification in 2 cases the defects corresponded to Type I, in1 case — Type IIA, in 4 cases — Type IIB (posttraumatic coxarthrosis), in 2 cases — Type IIIA, in 10 — Type IIIB out of them 2 cases with pelvic bone separation. Custom components were produced using the method of direct metal laser sintering (DMLS). The whole technologic process took from 4 to 8 weeks and was conducted jointly with the engineers. Results. Exact match of implant form and the defect was observed in 89.9% of cases. In 2 patients with pelvic bone separation additional correction of bone structures was required when placing the acetabular component. In radiograph from 2 to 8 months after surgery the constructions were stable.Conclusion. 3D technology for the custom-made acetabular components is a method of resolving the problem in patients with marked acetabular defects. It enables to plan the surgery, simplifies the choice for screws positioning avoiding their interference. The design features of the implant are three rigid flanges with screw holes that create additional contact with intact parts of the ischial, iliac and pubic bones. Screw fixation ensures initial rigid stability until the biological fixation is achieved.

scholarly journals Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

2020 ◽  
Author(s):  
Michael Stephan Gruber ◽  
Michael Jesenko ◽  
Julia Burghuber ◽  
Josef Hochreiter ◽  
Peter Ritschl ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Special Treatment ◽  
Center Of Rotation ◽  
Custom Made ◽  
Significant Difference ◽  
Oxford Hip Score ◽  
Acetabular Defects ◽  
Type 3 ◽  
Acetabular Components

Abstract Background Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects.Methods Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics.Results The mean follow-up time of the nine patients was 12.2 months (range: 10 - 18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset.Conclusions The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined.Level of Evidence: Therapeutic Level IV.

scholarly journals Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael S. Gruber ◽  
Michael Jesenko ◽  
Julia Burghuber ◽  
Josef Hochreiter ◽  
Peter Ritschl ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Special Treatment ◽  
Center Of Rotation ◽  
Custom Made ◽  
Significant Difference ◽  
Oxford Hip Score ◽  
Acetabular Defects ◽  
Type 3 ◽  
Acetabular Components

Abstract Background Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects. Methods Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics. Results The mean follow-up time of the nine patients was 12.2 months (range: 10–18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset. Conclusions The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined. Level of evidence Therapeutic Level IV.

scholarly journals Functional and Radiological Outcomes After Treatment with Custom-Made Acetabular Components in Patients with Paprosky type 3 Acetabular Defects: Short-Term Results

2020 ◽  
Author(s):  
Michael Stephan Gruber ◽  
Michael Jesenko ◽  
Julia Burghuber ◽  
Josef Hochreiter ◽  
Peter Ritschl ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Special Treatment ◽  
Level Of Evidence ◽  
Custom Made ◽  
Significant Difference ◽  
Oxford Hip Score ◽  
Acetabular Defects ◽  
Type 3 ◽  
Acetabular Components

Abstract BackgroundSevere acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects.MethodsSixteen patients were included in this trial, nine of whom completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics.ResultsThe mean follow-up time of the nine patients was 13.6 months (± 5.6 SD). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed no significant difference in offset measurements except for femoral offset (41.8 mm on the contralateral and 35.2 mm on the treated hip, p = 0.044).ConclusionsThe functional and radiological outcomes are promising. However, long-term outcomes still need to be examined.Level of Evidence: Therapeutic Level IV.

scholarly journals 3D Printed Acetabular Components for Complex Revision Arthroplasty

2021 ◽  
Author(s):  
Angela Yao ◽  
Daniel Mark George ◽  
Vijai Ranawat ◽  
Chris John Wilson
Keyword(s):  
Revision Arthroplasty ◽  
3D Printed ◽  
Acetabular Components

Proposal of custom made wrist orthoses based on 3D modelling and 3D printing

2017 ◽  
Author(s):  
Mauren Abreu de Souza ◽  
Cristiane Schmitz ◽  
Marcelo Marega Pinhel ◽  
Joao A. Palma Setti ◽  
Percy Nohama
Keyword(s):  
3D Printing ◽  
3D Modelling ◽  
Custom Made

Acute Type A Aortic Dissection Treated Using a Tubular Stent-Graft in the Ascending Aorta and a Multibranched Stent-Graft in the Aortic Arch

2016 ◽  
Vol 24 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Tilo Kölbel ◽  
Christian Detter ◽  
Sebastian W. Carpenter ◽  
Fiona Rohlffs ◽  
Yskert von Kodolitsch ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Open Surgery ◽  
Type A ◽  
Ascending Aorta ◽  
Type I ◽  
Acute Type ◽  
Stent Grafts ◽  
Type A Aortic Dissection ◽  
Custom Made

Purpose: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. Technique: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients. After preliminary carotid-subclavian bypass, a long Lunderquist guidewire was introduced from the right femoral artery to the left ventricle for delivery of the Zenith Ascend and Zenith Branched Arch Endovascular Grafts under inflow occlusion. Bridging stent-grafts were delivered to the innominate and left common carotid arteries to connect to the 2 inner branches; the left subclavian artery was occluded. Both cases were technically successful and resulted in exclusion of the false lumen in the ascending aorta. The operating and fluoroscopy times did not exceed those of comparable elective procedures. The patients were rapidly extubated shortly after the procedure and without serious immediate complications. One patient survived 11 months with a satisfactory repair; the other succumbed to complications of recurrent pneumonia after 23 days. Conclusion: Endovascular treatment of patients with acute type A aortic dissection using a combination of tubular and branched stent-grafts in the ascending aorta is feasible and offers an alternative strategy to open surgery.

Treatment of a type Ia endoleak following EVAR using a custom-made inner branch device.

Vascular ◽  
2021 ◽  
pp. 170853812110627
Author(s):  
Gino Gemayel GG ◽  
Michel Montessuit MM ◽  
Anouche Gemayel GA
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Open Surgery ◽  
Type I ◽  
Novel Technology ◽  
Abdominal Aortic ◽  
Custom Made ◽  
Type Ia ◽  
Type I Endoleak ◽  
Aortic Cuff

Objectives We represent two cases of late proximal type I endoleak following EVAR with aneurysm expansion that were treated with a custom-made graft with inner branches. Methods Two patients of 87 and 82 years old were operated by EVAR 6 and 8 years ago for abdominal aortic aneurysm. Both had proximal type I endoleak with aneurysm sac expansion. Open surgery had a high risk, and a proximal aortic extension with a simple aortic cuff was not possible neither because previous EVAR grafts were already at the level of the renal arteries. A custom-made endograft with inner branches was planned as a fenestrated graft was not technically possible. Results We successfully treated both patients using a custom-made graft with four inner branches from Jotec (Cryolife, Kennesaw, GA). Three months’ follow-up CT scan did not show any endoleaks. All target vessels were patent with good conformability of the bridging stents. Conclusion The treatment of proximal type I endoleak using inner branches’ endografts is feasible. This novel technology might broaden the indications for complex aortic repair in a group of patients where fenestrated endografts are not possible.

Limb-salvage reconstruction following resection of pelvic bone sarcomas involving the acetabulum

2021 ◽  
Vol 103-B (4) ◽  
pp. 795-803
Author(s):  
Tomohiro Fujiwara ◽  
Manuel Ricardo Medellin Rincon ◽  
Andrea Sambri ◽  
Yusuke Tsuda ◽  
Rhys Clark ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Major Complication ◽  
Ice Cream ◽  
Pelvic Bone ◽  
Limb Salvage Surgery ◽  
Consecutive Series ◽  
Major Complications ◽  
Custom Made ◽  
The Mean ◽  
Custom Made Prostheses

Aims Limb salvage for pelvic sarcomas involving the acetabulum is a major surgical challenge. There remains no consensus about what is the optimum type of reconstruction after resection of the tumour. The aim of this study was to evaluate the surgical outcomes in these patients according to the methods of periacetabular reconstruction. Methods The study involved a consecutive series of 122 patients with a periacetabular bone sarcoma who underwent limb-salvage surgery involving a custom-made prosthesis in 65 (53%), an ice-cream cone prosthesis in 21 (17%), an extracorporeal irradiated autograft in 18 (15%), and nonskeletal reconstruction in 18 (15%). Results The rates of major complications necessitating further surgery were 62%, 24%, 56%, and 17% for custom-made prostheses, ice-cream cone prostheses, irradiated autografts and nonskeletal reconstructions, respectively (p = 0.001). The ten-year cumulative incidence of failure of the reconstruction was 19%, 9%, 33%, and 0%, respectively. The major cause of failure was deep infection (11%), followed by local recurrence (6%). The mean functional Musculoskeletal Tumour Society (MSTS) scores were 59%, 74%, 64%, and 72%, respectively. The scores were significantly lower in patients with major complications than in those without complications (mean 52% (SD 20%) vs 74% (SD 19%); p < 0.001). For periacetabular resections involving the ilium, the mean score was the highest with custom-made prostheses (82% (SD 10%)) in patients without any major complication; however, nonskeletal reconstruction resulted in the highest mean scores (78% (SD 12%)) in patients who had major complications. For periacetabular resections not involving the ilium, significantly higher mean scores were obtained with ice-cream cone prostheses (79% (SD 17%); p = 0.031). Conclusion Functional outcome following periacetabular reconstruction is closely associated with the occurrence of complications requiring further surgery. For tumours treated with periacetabular and iliac resection, skeletal reconstruction may result in the best outcomes in the absence of complications, whereas nonskeletal reconstruction is a reasonable option if the risk of complications is high. For tumours requiring periacetabular resection without the ilium, reconstruction using an ice-cream cone prosthesis supported by antibiotic-laden cement is a reliable option. Cite this article: Bone Joint J 2021;103-B(4):795–803.

scholarly journals Two-stage revision arthroplasty in the treatment of periprosthetic hip infections with severe bone loss: Results from 182 cases

2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Jerzy Białecki ◽  
Maciej Kogut ◽  
Sławomir Chaberek ◽  
Paweł Bartosz ◽  
Marcin Obrębski ◽  
...  
Keyword(s):  
Bone Loss ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Bone Defects ◽  
Harris Hip Score ◽  
Two Stage ◽  
Retrospective Assessment ◽  
Severe Bone Loss ◽  
Paprosky Classification

The optimum treatment for periprosthetic joint infection (PJI) of the hip with substantial bone defects remains controversial. A retrospective assessment was performed for 182 patients treated for PJI with a two-stage protocol from 2005 to 2015. Implant removal and debridement were followed by Girdlestone arthroplasty or spacer implantation. The results of the Girdlestone and spacer groups were compared. There were 71 cases that received spacers, and 111 Girdlestone procedures were performed. After the first stage, 26.37% of cultures were negative, and among patients with a detected pathogen, methicillin-sensitive Staphylococcus aureus was the most common organism (41.79%). Acetabular and femoral bone defects, according to the Paprosky classification, were more severe in the Girdlestone group (P<0.05). During the follow-up (mean, 5.95 years), the overall incidence of complications was 21.42%. The mean Harris hip score was significantly lower in the Girdlestone group (68.39 vs 77.79; P<0.0001). The infection recurrence rate reached 8.79%. Despite satisfactory infection control, the number of complications and poor functional outcomes associated with resection arthroplasty indicate the necessity for development of different approaches for patients with advanced bone loss.

Sign in / Sign up

Export Citation Format

Share Document