Author/Authors :
Hughes, Andrew J. Department of Orthopaedic Surgery - St. Vincent’s University Hospital - Dublin, Ireland , DeBuitleir, Cathal Department of Orthopaedic Surgery - St. Vincent’s University Hospital - Dublin, Ireland , Soden, Philip Department of Orthopaedic Surgery - St. Vincent’s University Hospital - Dublin, Ireland , O’Donnchadha, Brian Department of Mechanical Engineering - Institute of Technology Tallaght - Dublin , Ireland , Tansey, Anthony Department of Mechanical Engineering - Institute of Technology Tallaght - Dublin , Ireland , Abdulkarim, Ali Department of Orthopaedic Surgery - Cappagh National Orthopaedic Hospital - Dublin, Ireland , Hurson, Conor J. Department of Orthopaedic Surgery - Cappagh National Orthopaedic Hospital - Dublin, Ireland , McMahon, Colm Department of Radiology - St. Vincent’s University Hospital - Dublin, Ireland
Abstract :
Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology andmanufacturing technology have made three-dimensional (3D) representation of osseous anatomy obtainable, which providevisual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip jointsin two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting inright-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stagerevision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images wereimported into Materialise MIMICS 14.12. The models were manufactured using selective laser sintering. Accurate templatingwas performed preoperatively. Acetabular cup, augment, buttress, and cage sizes were trialled using the models, before beingadjusted, and resterilised, enhancing the preoperative decision-making process. Screw trajectory simulation was carried out,reducing the risk of neurovascular injury. With 3D printing technology, complex pelvic deformities were better evaluated andtreated with improved precision. Life-size models allowed accurate surgical simulation, thus improving anatomical appreciationand preoperative planning. The accuracy and cost-effectiveness of the technique should prove invaluable as a tool to aid clinicalpractice.
