Purpose
To assess the value of 3D models of the hipjoint in surgical care,
utilising current preoperative cross-sectional imaging modalities.
Our institution is a tertiary referral centre for patients with complex hip pathology and is one of the largest specialist young adult hip units in the country.
According to a recent publication by Arthritis UK,
“In 2012 over 80,000 THRs were performed in the UK.
More than 1 in 10 of the THR (approximately 8,600) were revision THRs,
and there is evidence that the number of...
Methods and Materials
Preoperative CT data from 10 patients listed for CRHA were prospectively collected and digitally reconstructed using 3DP software.
All revision cases were discussed amongst three experienced hip-surgeons and a musculoskeletal radiologist,
who were asked to complete a written short questionnaire.
The level of complexity of the cases was ascertained by consensus amongst the surgeons.
Thereafter,
they were presented with the 3D model and asked to repeat the process and complete the questionnaire.
The written questionnaire included:
Proposed surgery
Proposed prosthesis and size(s)
Expected operative time...
Results
Case study (Patient 1):
A78 year old male,
who had a left total hip replacment 18 years ago.
Plain radiographs (Fig. 1 Fig. 2 Fig. 3) were obtained 7 years ago,
when he presented with occasional pain in the left hip joint,
associated withexcessive activity and relieved over time with rest.
In September 2016,
the patient presented with severe pain in his left hip and marked restriction of movements.
Plain radiographs obtained (Fig. 4 Fig. 5 Fig. 6) demonstrated loosening of the acetabular component with...
Conclusion
The configuration of the patient’s hip joint is often distorted due to mechanical failure,
the reaction at the interface between bone and the primary prosthesis,
underling osteoporosis as well as hardware failure with time.
Appreciation of the residual bony anatomy,
bone loss,
displacement of the surrounding soft tissues and the 3D spatial relationships between all four is critical to surgical planning.
3DP when married with medical imaging,
allows the reproduction of anatomy in a patient-specific model,
thus capturing the radiologist’s expert understanding of the CT...
References
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Personal Information
Dr Danoob Dalili
Specialist Registrar Clinical Radiology,
Imperial College London,
UK
Research fellow,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Nick Byrne
Medical Physicist,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Zameer Shah
Consultant Orthopaedic Hip Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Marcus J Bankes
Consultant Orthopaedic Hip Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Marc George
Consultant Orthopaedic Hip Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Dr...