Int J Med Robot - Preliminary application of computer-assisted patient-specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip.

Tópicos

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Resumo

CKGROUND: The considerable variation in anatomical abnormalities of hip joints associated with different types of developmental dysplasia of hip (DDH) makes reconstruction in total hip arthroplasty (THA) difficult. It is desirable to create patient-specific designs for THA procedures. In the cases of adult single DDH, an accuracy-improved method has been developed for acetabular cup prosthesis implantation of hip arthroplasty.METHODS: From October 2007 to November 2008, 22 patients with single DDH (according to the Crowe standard, all dysplasia hips were classified as type I) were scanned with spiral CT pre-operatively. These patients scheduled for THA were randomly assigned to undergo either conventional THA (control group, n=11) or navigation template implantation (NT group, n=11). In the NT group, three-dimensional (3D) CT pelvis image data were transferred to a computer workstation and 3D models of the hip were reconstructed using the Mimics software. The 3D models were then processed by the Imageware software. In brief, a template that best fitted the location and shape of the acetabular cup was 'reversely' built from the 3D model, the rotation centre of the pathological hip determined by mirroring that of the healthy site, and a guiding hole in the template was then designed. The navigational templates were manufactured using a rapid prototyping machine. These navigation templates guide acetabular component placement.RESULTS: Based on the predetermined abduction angle 45? and anteversion angle 18?, after 1year follow-up, the NT group showed significantly smaller differences (1.6??0.4?, 1.9??1.1?) from the predetermined angles than those in the control group (5.8??2.9?, 3.9??2.5?) (P<0.05).CONCLUSIONS: The template designs facilitated accurate placement of acetabular components in dysplasia of acetabulum. The hip's center of rotation in DDH could be established using computer-aided design, which provides a useful method for the accurate location of prosthesis with a low cost-performance ratio without excessive technical workload on the surgical team.

Resumo Limpo

ckground consider variat anatom abnorm hip joint associ differ type development dysplasia hip ddh make reconstruct total hip arthroplasti tha difficult desir creat patientspecif design tha procedur case adult singl ddh accuracyimprov method develop acetabular cup prosthesi implant hip arthroplastymethod octob novemb patient singl ddh accord crow standard dysplasia hip classifi type scan spiral ct preoper patient schedul tha random assign undergo either convent tha control group n navig templat implant nt group n nt group threedimension d ct pelvi imag data transfer comput workstat d model hip reconstruct use mimic softwar d model process imagewar softwar brief templat best fit locat shape acetabular cup revers built d model rotat centr patholog hip determin mirror healthi site guid hole templat design navig templat manufactur use rapid prototyp machin navig templat guid acetabular compon placementresult base predetermin abduct angl antevers angl year followup nt group show signific smaller differ predetermin angl control group pconclus templat design facilit accur placement acetabular compon dysplasia acetabulum hip center rotat ddh establish use computeraid design provid use method accur locat prosthesi low costperform ratio without excess technic workload surgic team

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