Type:
Educational Exhibit
Keywords:
Performed at one institution, Not applicable, Prostheses, Image verification, Education and training, Decision analysis, Computer Applications-Virtual imaging, Computer Applications-3D, Image manipulation / Reconstruction, Experimental, CT, Pelvis, Musculoskeletal bone, Computer applications, Musculoskeletal
Authors:
R. Prost1, M. Giuseppe2, A. Capone2; 1Cagliari, Cagliari/IT, 2Cagliari/IT
DOI:
10.26044/ecr2020/C-14761
Background
Periprosthetic acetabular fractures are related to traumatic events and pathologic underlining conditions that reduce the structural integrity of supporting bone[1] and often are associated with aseptic loosening, periprosthetic osteolysis and severe bone loss[2].
Analysis based on standard radiographs alone are not suitable to reliably detect the residual stability of the implant and measure the extent of the fracture and pelvic bone loss [3].
CT scan is the gold standard to define the fracture pattern, especially with 3D virtual rendering reconstructions and specific metal artefact reduction (MAR) protocols [4], [5].
The development of novel, CT-based, 3D modeling software allows to obtain precise tridimensional reconstructions of the bony surface, virtually removing the metallic implants trough image segmentation [6].
Additional analytics tools allows the characterization of the fracture, the measurement of the remaining bone stock and the evaluation of implant stability[7].
Moreover, the 3D images can be printed in real-life size plastic models and used for preoperative implant templating, sizing and surgical simulation [8][9]. Clinical application of 3D digital and printed models in orthopedics have been focused particularly in primary and revision arthroplasty for the development of patient-specific instrumentation (PSI) and custom implants[6][10]. Fewer reports described its use for the preoperative planning and templating of complex pelvic and acetabular fractures[11][12].
In the current EPOS we present our application of 3D modeling and 3D printing techniques in the diagnostic and surgical planning of periprosthetic acetabular fracture around THA.