Use of Three-dimensional Printing and Patient-matched Implant in Total Hip Arthroplasty – a Case Study

2019 ◽  
Vol 21 (3) ◽  
pp. 207-216 ◽  
Author(s):  
Piotr Sypień ◽  
Paweł Łęgosz ◽  
Paweł Małdyk
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Revision Arthroplasty ◽  
Patient Specific ◽  
Oral Antibiotic ◽  
Precise Position ◽  
Total Hip ◽  
Custom Made ◽  
History Of

We present a case report of a 70-year-old female patient with a history of right hip dysplasia and total hip arthroplasty complicated by chronic periprosthetic hipction. Failure of oral antibiotic treatment was an indication for implant removal. A computed tomography scan performed during qualification for reimplantation revealed massive bone defects in the pelvis. A three-dimensional printed patient-specific anatomical model of the pelvis helped to determine the precise position and cup size in preoperative planning and prepare a patient-matched acetabulum. The custom-made endoprosthesis was implanted during revision arthroplasty.

scholarly journals Advances and innovations in total hip arthroplasty

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 26
Author(s):  
Andreas Fontalis ◽  
Jean-Alain Epinette ◽  
Martin Thaler ◽  
Luigi Zagra ◽  
Vikas Khanduja ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Young Patients ◽  
Cost Effective ◽  
Patient Specific ◽  
Three Dimensional Printing ◽  
Total Hip ◽  
Patient Specific Instrumentation ◽  
Dimensional Printing

Total hip arthroplasty (THA) has been quoted as one of the most successful and cost-effective procedures in Orthopaedics. The last decade has seen an exponential rise in the number of THAs performed globally and a sharp increase in the percentage of young patients hoping to improve their quality of life and return to physically demanding activities. Hence, it is imperative to review the various applications of technology in total hip arthroplasty for improving outcomes. The development of state-of-the-art robotic technology has enabled more reproducible and accurate acetabular positioning, while long-term data are needed to assess its cost-effectiveness. This opinion piece aims to outline and present the advances and innovations in total hip arthroplasty, from virtual reality and three-dimensional printing to patient-specific instrumentation and dual mobility bearings. This illustrates and reflects the debate that will be at the centre of hip surgery for the next decade.

scholarly journals Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Paweł Łęgosz ◽  
Maciej Otworowski ◽  
Aleksandra Sibilska ◽  
Krzysztof Starszak ◽  
Daniel Kotrych ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Heterotopic Ossification ◽  
Hip Arthroplasty ◽  
Previous History ◽  
Revision Arthroplasty ◽  
Total Hip ◽  
History Of ◽  
Turnover Markers ◽  
The One

Background. This review is intended to summarize the risk factors, classification, diagnosis, and treatment of heterotopic ossification (HO) of previously published studies. Results. Heterotopic ossification is a common complication of total hip arthroplasty. Its prevalence is not the same in all of the patient groups. Frequency of HO varies from 15 to 90%. Hip ankylosis, male gender, and previous history of HO are said to be risk factors with a significant level. Diagnosis is based on a single AP radiograph: the Brooker classification that divides HO into four grades is the most commonly used. The confirmation test that can be used is a bone scan. A great amount of bone metabolic turnover markers have been tested, but none of them seems to be relevant in case of prevention or diagnosis of HO. The most effective prophylactic treatment is radiotherapy or administration of nonsteroidal anti-inflammatory drugs. Over the years a lot of different RT protocols have been tested. Nowadays the most often used regimen is 7 Gy given postoperatively in a single dose. The most commonly prescribed drug in prophylaxis of HO is indomethacin. Also, the efficacy of ibuprofen and diclofenac was proven. Recently researchers focused on selective COX-2 inhibitors. They appear to be as effective as nonselective NSAIDs having less side effects. The one and only treatment of HO is a revision arthroplasty.

Reliability of Total Nucleated Cell Counts in the Setting of Hip Arthroplasty

2020 ◽  
Author(s):  
Lauren N Pearson ◽  
Robert L Schmidt ◽  
Kenneth Cahoon ◽  
Christopher E Pelt
Keyword(s):  
Synovial Fluid ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Debris ◽  
Total Hip ◽  
Cell Counts ◽  
History Of ◽  
Joint Effusions ◽  
Automated Instruments ◽  
Automated Methods

Abstract Background Total nucleated cell (TNC) count and differential are used to classify joint effusions as inflammatory or noninflammatory. Further diagnostic evaluation and management is contingent on this classification. TNC count can be measured by automated analyzers or by manual assessment using a hemocytometer. Studies have raised concerns regarding the accuracy of TNC counts measured by automated instruments, particularly in the setting of joint arthroplasty. The objective of this study was to determine whether metallosis, a complication of total hip arthroplasty in which metal debris accumulates in periprosthetic tissues and synovial fluid, is associated with inaccurate TNC counts in synovial fluid. Methods We compared the accuracy of cell counts measured by the Sysmex XN-1000 and Beckman Coulter Iris iQ200 with the gold standard of manual assessment using a hemocytometer in synovial fluid from patients with suspected metallosis and in fluid obtained from controls from patients with native joints and a history of arthroplasty for other indications. Results TNC counts produced by automated analyzers were associated with increased levels of discordance (relative to manual counts) in patients with metallosis. Metallosis was not associated with increased levels of discordance for RBC counts or WBC differentials. The Sysmex XN flagged all but 1 metallosis sample for manual verification of the results. Conclusions Automated methods are generally reliable for analysis of synovial fluid. TNC counts can be inaccurate in the context of metallosis following total hip arthroplasty. Laboratories should correlate automated cell counts with a microscopic assessment of the specimen, as recommended by instrument manufacturers.

Custom-Made Femoral Implants in Total HIP Arthroplasty Due to Congenital Disease of the HIP: A Review

2016 ◽  
Vol 26 (3) ◽  
pp. 209-214 ◽  
Author(s):  
Dimitrios T. Tsiampas ◽  
Emilios E. Pakos ◽  
Georgios C. Georgiadis ◽  
Theodoros A. Xenakis
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Congenital Disease ◽  
Total Hip ◽  
Custom Made ◽  
Femoral Implants

scholarly journals The Usefulness of Three-dimensional Computed Tomography as an Assessment of Periacetabular Osteolysis in Revision Total Hip Arthroplasty

Hip & Pelvis ◽  
2015 ◽  
Vol 27 (2) ◽  
pp. 90 ◽  
Author(s):  
Kyoung Ho Moon ◽  
Joon Soon Kang ◽  
Man Hee Won ◽  
Myoung Joo Park ◽  
Jae Hwang Choi
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip

Redesign of the Femoral Stem for a Total Hip Arthroplasty for Additive Manufacturing

2018 ◽  
Author(s):  
Bradley Hanks ◽  
Shantanab Dinda ◽  
Sanjay Joshi
Keyword(s):  
Additive Manufacturing ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lattice Structure ◽  
Stress Shielding ◽  
Patient Specific ◽  
Hip Implants ◽  
Hip Implant ◽  
Total Hip ◽  
Multiple Materials

Total hip arthroplasty (THA) is an increasingly common procedure that replaces all or part of the hip joint. The average age of patients is decreasing, which in turn increases the need for more durable implants. Revisions in hip implants are frequently caused by three primary issues: femoral loading, poor fixation, and stress shielding. First, as the age of hip implant patients decreases, the hip implants are seeing increased loading, beyond what they were traditionally designed for. Second, traditional implants may have roughened surfaces but are not fully porous which would allow bone to grow in and through the implant. Third, traditional implants are too stiff, causing more load to be carried by the implant and shielding the bone from stress. Ultimately this stress shielding leads to bone resorption and implant loosening. Additive manufacturing (AM) presents a unique opportunity for enhanced performance by allowing for personalized medicine and increased functionality through geometrically complex parts. Much research has been devoted to how AM can be used to improve surgical implants through lattice structures. To date, the authors have found no studies that have performed a complete 3D lattice structure optimization in patient specific anatomy. This paper discusses the general design of an AM hip implant that is personalized for patient specific anatomy and proposes a workflow for optimizing a lattice structure within the implant. Using this design workflow, several lattice structured AM hip implants of various unit cell types are optimized. A solid hip implant is compared against the optimized hip implants. It appears the AM hip implant with a tetra lattice outperforms the other implant by reducing stiffness and allowing for greater bone ingrowth. Ultimately it was found that AM software still has many limitations associated with attempting complex optimizations with multiple materials in patient specific anatomy. Though software limitations prevented a full 3D optimization in patient specific anatomy, the challenges associated such an approach and limitations of the current software are discussed.

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