Effects of 3D Imaging on Surgical Tactics in Primary and Revision Hip Arthroplasty

Cover Page

Abstract

3D imaging tools significantly expand the ability to assess the bone tissue condition, both in terms of its qualitative properties and in terms of accurate determination of bone defect geometry and volume.

The purpose of the study was to determine the 3D imaging potential for the preoperative planning and correction of surgical tactics in hip arthroplasty.

Materials and Methods. A retrospective analysis of the preoperative planning of 110 primary and revision hip arthroplasties with 3D imaging was performed. The following specialized software were employed: RadiAnt DICOM Viewer file converter — for 3D models production; 3D/CAD designers — for volumetric models processing and correction; InVesalius 3.0 program — for bone density evaluation by the Hounsfield scale; K-Pacs — for viewing MSCT and X-ray images. All patients underwent pelvic bones radiography in the front and anterior-lateral planes. Post-traumatic acetabular deformity was described in accordance with the X-ray picture in each individual clinical case. For revision arthroplasty, the acetabular defect was determined according to the W.G. Paprosky classification. In 36 patients (32.7%), the acetabulum defect was the result of trauma. In 74 patients (67.3%), the cause of surgery was endoprosthesis components loosening.

Results. In 80% of cases (88 patients), the analysis of the 3D model did not change the surgical tactics determined in the preoperative planning using pelvic radiographs; in 20% of cases (22 patients), the use of 3D imaging revealed new circumstances and changed the surgical tactics.

Conclusion. In standard cases, it is possible to use the traditional preoperative planning using radiographs in several planes. In primary hip arthroplasty in the patients with post-traumatic deformity, including a false joint of acetabulum bottom or 2 to 3 degree osteopenia, it is advisable to perform 3D imaging. In the case of revision arthroplasty, 3D visualization is indicated in acetabulum Paprosky IIIA, IIIB defects with pelvic discontinuity.

About the authors

V. A. Bazlov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: sbazlov@yandex.ru

Vyacheslav A. Bazlov — Researcher, Department of Arthroplasty and Arthroscopy

Novosibirsk

Russian Federation

T. Z. Mamuladze

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Tariel Z. Mamuladze — Researcher, Department of Arthroplasty and Arthroscopy

Novosibirsk

Russian Federation

O. I. Golenkov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Oleg I. Golenkov — Orthopedic Surgeon

Novosibirsk

Russian Federation

M. V. Efimenko

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Maxim V. Efimenko — Orthopedic Surgeon

Novosibirsk

Russian Federation

A. A. Pronskikh

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Alexander A. Pronskikh — Cand. Sci. (Med.), Researcher, Department of Arthroplasty and Arthroscopy

Novosibirsk

Russian Federation

K. N. Kharitonov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Konstantin N. Kharitonov — Orthopedic Surgeon

Novosibirsk

Russian Federation

A. A. Panchenko

Logeeks Medical Systems

Email: fake@neicon.ru

Andrey A. Panchenko — Technical Director

Novosibirsk

Russian Federation

V. V. Pavlov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Vitaly V. Pavlov — Dr. Sci. (Med.), Head of the Department of Traumatology and Orthopedics

Novosibirsk

Russian Federation

References

  1. Коваленко А.Н., Джавадов A.A., Шубняков И.И., Билык С.С., Денисов А.О., Черкасов М.А. и др. Среднесрочные результаты использования индивидуальных конструкций при ревизионном эндопротезировании тазобедренного сустава. Травматология и ортопедия России. 2019;25(3):37-46. doi: 10.21823/2311-2905-2019-25-3-37-46.
  2. Gwam C.U., Mistry J.B., Mohamed N.S., Thomas M., Bigart K.S., Mont M.A., Delanois R.E. Current epidemiology of revision total hip arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty. 2019;32(7):2088-2092. doi: 10.1016/j.arth.2017.02.046.
  3. Patel A., Pavlou G., Mujica-Mota R.E., Toms A.D. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J. 2015;97-B(8):1076-1081. doi: 10.1302/0301-620X.97B8.35170.
  4. Kowalik T.D., DeHart M., Gehling H., Gehling P., Schabel K., Duwelius P., Mirza A. The epidemiology of primary and revision total hip arthroplasty in teaching and nonteaching hospitals in the United States. J Am Acad Orthop Surg. 2016;24(6):393-398. doi: 10.5435/JAA0S-D-15-00596.
  5. Yoon P.W., Lee Y.K., Ahn J., Jang E.J., Kim Y., Kwak H.S. et al. Epidemiology of hip replacements in Korea from 2007 to 2011. J Korean Med Sci. 2014;29(6):852-858. doi: 10.3346/jkms.2014.29.6.852.
  6. Jafari S.M., Coyle C., Mortazavi S.M., Sharkey P.F., Parvizi J. Revision hip arthroplasty: infection is the most common cause of failure. Clin Orthop Relat Res. 2010;468(8):2046-2051. doi: 10.1007/s11999-010-1251-6.
  7. Hosny H.A.H., El-Bakoury A., Fekry H., Keenan J. Mid-term results of graft augmentation prosthesis II cage and impacted allograft bone in revision hip arthroplasty. J Arthroplasty. 2018;33(5):1487-1493. doi: 10.1016/j.arth.2017.11.060.
  8. Deirmengian G.K., Zmistowski B., O’Neil J.T., Hozack W.J. Management of acetabular bone loss in revision total hip arthroplasty. J Bone Joint Surg Am. 2011;93(19): 1842-1852. doi: 10.2106/jbjs.j.01197.
  9. Von Roth P., Abdel M.P., Harmsen W.S., Berry D.J. Uncemented jumbo cups for revision total hip arthroplasty: a concise follow-up, at a mean of twenty years, of a previous report. J Bone Joint Surg Am. 2015; 97(4):284-287. doi: 10.2106/jbjs.n.00798.
  10. Amenabar T., Rahman W.A., Hetaimish B.M., Kuzyk P.R., Safir O.A., Gross A.E. Promising mid-term results with a cup-cage construct for large acetabular defects and pelvic discontinuity. Clin Orthop Relat Res. 2016;474(2):408-414. doi: 10.1007/s11999-015-4210-4.
  11. Садовой М.А., Павлов В.В., Базлов В.А., Мамуладзе Т.З., Ефименко М.В., Аронов А.М., Панченко А.А. Возможности объемной визуализации в предоперационном планировании ревизионного эндопротезирования тазобедренного сустава. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2017;(3):37-42.
  12. Хоружик С.А., Михайлов А.Н. Основы КТ-визуализации. Часть 1. Просмотр и количественная оценка изображений. Радиология-практика. 2011;(3):62-75.
  13. Paprosky W.G., Perona P.G., Lawrence J.M. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994;9(1):33-44. doi: 10.1016/0883-5403(94)90135-x.
  14. Рукин Я., Мурылев В., Лычагин А., Елизаров П., Грицюк А., Явлиева Р. Ревизионное эндопротезирование тазобедренного сустава у пациентов с диссоциацией костей таза. Врач. 2017;(12):66-70.
  15. Павлов В.В., Пронских А.А., Мамуладзе Т.З., Базлов В.А., Ефименко М.В., Жиленко В.Ю., Цегельников М.М. Лечение пациента с обширным постимплантационным дефектом костей таза. Травматология и ортопедия России. 2018;24(3):125-134. doi: 10.21823/2311-2905-2018-24-3-125-134.
  16. Baauw M., van Hellemondt G.G., van Hooff M.L., Spruit M. The accuracy of positioning of a custom-made implant within a large acetabular defect at revision arthroplasty of the hip. Bone Joint J. 2015;97-B(6):780-785. doi: 10.1302/0301-620X.97B6.35129.
  17. Корыткин А.А., Смирнов А.А., Захарова Д.В., Новикова Я.С., Ковалдов К.А., Эль Мудни Ю.М. Опыт использования аппаратов внешней фиксации в условиях ригидных деформаций тазобедренного сустава на этапе предоперационной подготовки и планирования сложных случаев первичного и ревизионного эндопротезирования. Гений ортопедии. 2018;24(1): 18-23. doi: 10.18019/1028-4427-2018-24-1-18-23.
  18. Коваленко A.H., Тихилов Р.М., Билык С.С., Шубняков И.И., Черкасов М.А., Денисов А.О. Позиционирование индивидуальных вертлужных компонентов при ревизиях тазобедренного сустава: действительно ли они подходят как «ключ к замку»? Вестник травматологии и ортопедии им. Н.Н. Приорова. 2017;(4):31-37. doi: 10.32414/0869-8678-2017-4-31-37.
  19. Кавалерский Г.М., Мурылев В.Ю., Рукин Я.А., Елизаров П.М., Дженжера Е. 3D-технологии при ревизионном эндопротезировании тазобедренного сустава. Врач. 2016;(11):47-49.
  20. Berasi C.C., Berend K.R., Adams J.B., Ruh E.L, Lombardi A.V. Are custom triflange acetabular components effective for reconstruction of catastrophic bone loss? Clin Orthop Relat Res. 2015;473(2):528-535. doi: 10.1007/s11999-014-3969-z.
  21. Тихилов Р.М., Шубняков И.И., Коваленко А.Н., Билык С.С., Цыбин А.В., Денисов А.О., Дмитревич Г.Д., Вопиловский П.Н. Применение индивидуальной трехфланцевой конструкции при ревизионном эндопротезировании с нарушением целостности тазового кольца (клинический случай). Травматология и ортопедия России. 2016;(1):108-116. doi: 10.21823/2311-2905-2016-0-1-108-116.
  22. Корыткин А.А., Захарова Д.В., Новикова Я.С., Горбатов Р.О., Ковалдов К.А., Эль Мудни Ю.М. Опыт применения индивидуальных трехфланцевых вертлужных компонентов при ревизионном эндопротезировании тазобедренного сустава. Травматология и ортопедия России. 2017;23(4): 101-111. doi: 10.21823/2311-2905-2017-23-4-101-111.
  23. Kavalerskiy G.M., Murylev V.Y., Rukin Y.A., Elizarov P.M., Lychagin A.V., Tselisheva E.Y. Three-dimensional models in planning of revision hip arthroplasty with complex acetabular defects. Indian J Orthop. 2018;52(6):625-630. doi: 10.4103/ortho.IJOrtho_556_16.
  24. Baauw M., van Hellemondt G.G., van Hooff M.L., Spruit M. The accuracy of positioning of a custom-made implant within a large acetabular defect at revision arthroplasty of the hip. Bone Joint J. 2015; 97-B(6):780-785. doi: 10.1302/0301-620X.97B6.35129.

Statistics

Views

Abstract: 218

Dimensions

Article Metrics

Metrics Loading ...

PlumX


Copyright (c)



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies