Curative effect and prognosis of 3D printing titanium alloy trabecular cup and pad in revision of acetabular defect of hip joint

Objective. To analyze the effect of PFNA-II internal fixation on hip joint recovery and quality of life (QOL) in patients with lateral-wall dangerous type of intertrochanteric fracture. Methods. One hundred and twelve patients with lateral-wall dangerous type of intertrochanteric fracture who underwent surgical treatment in our hospital from May 2017 to May 2019 were selected as the participants of the study. Based on the treatment method, all the enrolled patients were divided into two groups: proximal femoral nail antirotation (PFNA group; n = 59 ) who received closed reduction and minimally invasive PFNA internal fixation and dynamic hip screw group (DHS; n = 53 ) who received internal fixation. The clinical indicators, curative effect, hip function score, pain degree, postoperative QOL score, and complications were compared between the two groups. Results. The operation time, intraoperative blood loss, postoperative drainage volume, and the incidence of postoperative complications in PFNA group were statistically lower than those in DHS group ( P < 0.05 ). The curative effect in PFNA group was notably better than that in DHS group. There were no significant differences in scores of hip function, visual analogue scale (VAS), and QOL between the two groups before operation ( P > 0.05 ). However, the hip function score and QOL score increased in both groups after surgery, and the increase was more significant in the PFNA group, while the VAS score decreased in both groups, and the decrease in PFNA group was more significant ( P < 0.05 ). Conclusion. PFNA internal fixation for the treatment of lateral-wall dangerous type of intertrochanteric fracture has the advantages of short operation time, less intraoperative blood loss, effective improvement of hip joint function, and fewer postoperative complications, which is worthy of clinical application.

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Treatment of an extensive acetabular defect in a patient with aseptic instability of a total hip arthroplasty

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto202027360-66 ◽

2020 ◽

Vol 27 (3) ◽

pp. 60-66

Author(s):

Hovakim A. Aleksanyan ◽

Hamlet A. Chragyan ◽

Sergey V. Kagramanov ◽

Nikolay V. Zagorodniy

Keyword(s):

Acetabular Component ◽

Hip Joint ◽

Revision Arthroplasty ◽

Acetabular Defect ◽

Total Arthroplasty ◽

Total Endoprosthesis ◽

Reconstructive Operations ◽

Fresh Frozen ◽

Joint Revision ◽

The Right

The aim of the study is to demonstrate, using a clinical example, the possibility of treating a patient with a severe acetabular defect by performing a one-stage revision arthroplasty using an individual design. Materials and methods. A 45-year-old female patient was admitted with complaints of pain, limitation of movement in the right hip joint, and gait disturbance. From anamnesis at the age of 5 years, reconstructive operations of the hip joints were performed. In 1991, CITO performed primary total arthroplasty of the right hip joint with an endoprosthesis from ESKA Implants. In 1998, due to the instability of the acetabular component of the total endoprosthesis of the right hip joint, revision arthroplasty was performed, and the cup was placed with a cement fixation. In 2001, for left-sided dysplastic coxarthrosis, primary total arthroplasty of the left hip joint was performed. In 2012, due to the instability of the total endoprosthesis of the left hip joint, revision arthroplasty was performed using an ESI anti-protrusion ring (ENDOSERVICE) with a cement cup and a Zweimller-type femoral component; the femur defect was repaired using a fresh frozen cortical graft. In October 2019, instability of the total endoprosthesis of the right hip joint was revealed, for which revision endoprosthetics was performed using an individual acetabular component. Results. The HHS index before revision arthroplasty was 21 points, after 1 month after surgery 44 points, after 3 months after surgery 65, after 6 months 82. Quality of life was assessed according to the WOMAC scale: before surgery 73 points, after 1 month after surgery 54 points, after 3 months 31, after 6 months 15 points. At the time of the last consultation, the patient moves with a cane, lameness persists, associated with scar reconstruction and atrophy of the gluteal muscles. Conclusion. The use of individual structures allows to restore the support ability of the lower limb and the function of the hip joint in the case of an extensive defect of the pelvic bones of the pelvic discontinuity type.

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Comparison analysis of titanium alloy Ti6Al4V produced by metallurgical and 3D printing method

10.1063/1.5091886 ◽

2019 ◽

Cited By ~ 4

Author(s):

Karolina Karolewska ◽

Bogdan Ligaj

Keyword(s):

Titanium Alloy ◽

3D Printing ◽

Comparison Analysis ◽

Titanium Alloy Ti6al4v ◽

Printing Method

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Individualized artificial titanium alloy spinal lamina with 3D printing technology

Materials Express ◽

10.1166/mex.2020.1678 ◽

2020 ◽

Vol 10 (5) ◽

pp. 648-656

Author(s):

Jianwen Li ◽

Songbo Li ◽

Xianyin Liu ◽

Fuxin Wei ◽

Xiaoshuai Wang ◽

...

Keyword(s):

Titanium Alloy ◽

3D Printing ◽

Spinal Canal ◽

Lumbar Vertebrae ◽

Printing Technology ◽

3D Printing Technology ◽

Attachment Point ◽

Post Surgery ◽

Anteroposterior Diameter ◽

Posterior Ligament

Background: Laminectomy and decompression is a common procedure for treating spine diseases. However, due to the lack of a posterior, bony braced structure, the dural sac and nerve roots can adhere to the surrounding tissues, and scar formation can occur in muscle and soft tissues. This can cause new compression post surgery, and failure of the operation. Objective: This study aimed to produce an individualized titanium alloy spine lamina using 3D printing technology, and to evaluate its effectiveness by implantation in human cadaveric spines. Methods: Six adult lumbar cadaver specimens were used, and computed tomography (CT) was used to obtain DICOM medical digital image standard data. The lumbar vertebrae structure was reconstructed by three-dimensional (3D) modeling software, and then simulated lumbar laminectomy was performed. Based on the characteristics of the original lamina, an artificial spine lamina was designed, including suture holes at the posterior ligament attachment point and a locking screw hole for fixation. A titanium alloy spine lamina was fabricated by 3D printing, and a guide plate to assist artificial lamina implantation was designed. Using the guide plated, L4 lumbar vertebrae segment laminectomy was performed on the 6 lumbar spine specimens, titanium alloy spine lamina were implanted and fixed with cortical bone trajectory screws. After implantation, CT was performed to record the length of the screw, the trajectory of the screw in the pedicle, and changes of bony spinal canal volume and anteroposterior diameter of the spinal canal. Results: The morphology of artificial spine lamina matched that of the original lamina. The artificial lamina was easy to implant, and matched the original lamina. The laminas were fixed by 12 cortical screws (diameter, 4.5 mm; median length, 34.67 ± 1.97 mm). CT scan indicated that all screws passed through the pedicle cortex by < 2 mm (2 screws penetrated the inner wall). The bony canal volume of the L4 vertebral pedicle was 311.23 ± 38.17 mm2 before operation and 356.17 ± 43.11 mm2 after operation, and there was statistical difference (P < 0.001). The anteroposterior diameter of spinal canal was 17.82 ± 2.03 mm before surgery and 20.67 ± 2.38 mm after surgery, and they were statistically different (P < 0.001). Conclusion: An individualized artificial titanium alloy spine lamina designed and produced with 3D printing technology can be used to reconstruct the structure of the posterior spine complex after lumbar laminectomy. The artificial lamina can increase the volume of the spinal canal and provide a posterior ligament reconstruction attachment point.

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The biological response to laser-aided direct metal-coated Titanium alloy (Ti6Al4V)

Bone and Joint Research ◽

10.1302/2046-3758.75.bjr-2017-0222.r1 ◽

2018 ◽

Vol 7 (5) ◽

pp. 357-361 ◽

Cited By ~ 1

Author(s):

T. Shin ◽

D. Lim ◽

Y. S. Kim ◽

S. C. Kim ◽

W. L. Jo ◽

...

Keyword(s):

Cell Proliferation ◽

Alkaline Phosphatase ◽

Titanium Alloy ◽

3D Printing ◽

Bone Ingrowth ◽

Biological Response ◽

Coated Surfaces ◽

Titanium Alloy Ti6al4v ◽

Net Shaping

Objectives Laser-engineered net shaping (LENS) of coated surfaces can overcome the limitations of conventional coating technologies. We compared the in vitro biological response with a titanium plasma spray (TPS)-coated titanium alloy (Ti6Al4V) surface with that of a Ti6Al4V surface coated with titanium using direct metal fabrication (DMF) with 3D printing technologies. Methods The in vitro ability of human osteoblasts to adhere to TPS-coated Ti6Al4V was compared with DMF-coating. Scanning electron microscopy (SEM) was used to assess the structure and morphology of the surfaces. Biological and morphological responses to human osteoblast cell lines were then examined by measuring cell proliferation, alkaline phosphatase activity, actin filaments, and RUNX2 gene expression. Results Morphological assessment of the cells after six hours of incubation using SEM showed that the TPS- and DMF-coated surfaces were largely covered with lamellipodia from the osteoblasts. Cell adhesion appeared similar in both groups. The differences in the rates of cell proliferation and alkaline phosphatase activities were not statistically significant. Conclusions The DMF coating applied using metal 3D printing is similar to the TPS coating, which is the most common coating process used for bone ingrowth. The DMF method provided an acceptable surface structure and a viable biological surface. Moreover, this method is automatable and less complex than plasma spraying. Cite this article: T. Shin, D. Lim, Y. S. Kim, S. C. Kim, W. L. Jo, Y. W. Lim. The biological response to laser-aided direct metal-coated Titanium alloy (Ti6Al4V). Bone Joint Res 2018;7:357–361. DOI: 10.1302/2046-3758.75.BJR-2017-0222.R1.

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