While total hip arthroplasty (THA) is a common orthopedic procedure for treatment of hip arthritis, current techniques demonstrate poor implant alignment accuracy and precision, which is critical to the replacement's long-term survivorship. Patient-specific instruments to guide bone preparation and implantation could improve accuracy, thereby improving replacement survivorship. A single cadaver was CT (computer tomography) scanned to extract the 3D bone geometry, from which the operating surgeon planned a THA. Patient-specific guides were designed, 3D printed, and used in the cadaveric THA procedure. Postprocedural CT data were used to compare measured implant positioning versus the preprocedural template. Implanted component accuracy ranged from 1 deg–12 deg.
Issue Section:
Research Papers
References
1.
Kurtz
, S. M.
, Ong
, K.
, Lau
, E.
, Mowat
, F.
, and Halpern
, M.
, 2007
, “Projections of Primary and Revision Hip and Knee Arthroplasty in the United States From 2005 to 2030
,” J. Bone Joint Surg. Am.
, 89
(4
), pp. 780
–785
.10.2106/JBJS.F.002222.
Ulrich
, S. D.
, Seyler
, T. M.
, Bennett
, D.
, Delanois
, R. E.
, Saleh
, K. J.
, Thongtrangan
, I.
, Kuskowski
, M.
, Cheng
, E. Y.
, Sharkey
, P. F.
, Parvizi
, J.
, Stiehl
, J. B.
, and Mont
, M. A.
, 2008
, “Total Hip Arthroplasties: What are the Reasons for Revision?
,” Int. Orthop.
, 32
(5
), pp. 597
–604
.10.1007/s00264-007-0364-33.
Kennedy
, J. G.
, Rogers
, W. B.
, Soffe
, K. E.
, Sullivan
, R. J.
, Griffen
, D. G.
, and Sheehan
, L. J.
, 1998
, “Effect of Acetabular Component Orientation on Recurrent Dislocation, Pelvic Osteolysis, Polyethylene Wear, and Component Migration
,” J. Arthroplasty
, 13
(5
), pp. 530
–534
.10.1016/S0883-5403(98)90052-34.
Patel
, A. B.
, Wagle
, R. R.
, Usrey
, M. M.
, Thompson
, M. T.
, Incavo
, S. J.
, and Noble
, P. C.
, 2010
, “Guidelines for Implant Placement to Minimize Impingement During Activities of Daily Living After Total Hip Arthroplasty
,” J. Arthroplasty
, 25
(8
), pp. 1275
–1281
.10.1016/j.arth.2009.10.0075.
Malik
, A.
, Maheshwari
, A.
, and Dorr
, L. D.
, 2007
, “Impingement With Total Hip Replacement
,” J. Bone Joint Surg. Am.
, 89
(8
), pp. 1832
–1842
.10.2106/JBJS.F.013136.
Woolson
, S. T.
, Hartford
, J. M.
, and Sawyer
, A.
, 1999
, “Results of a Method of Leg-Length Equalization for Patients Undergoing Primary Total Hip Replacement
,” J. Arthroplasty
, 14
(2
), pp. 159
–164
.10.1016/S0883-5403(99)90119-57.
Isaac
, G. H.
, Schmalzried
, T. P.
, and Vail
, T. P.
, 2009
, “Component Mal- Position: The ‘Achilles' Heel’ of Bearing Surfaces in Hip Replacement
,” Proc. Inst. Mech. Eng. Part J
, 223
(3
), pp. 275
–286
.10.1243/13506501JET5548.
Bozic
, K. J.
, Kurtz
, S. M.
, Lau
, E.
, Ong
, K.
, Vail
, T. P.
, and Berry
, D. J.
, 2009
, “The Epidemiology of Revision Total Hip Arthroplasty in the United States
,” J. Bone Joint Surg. Am.
, 91
(1
), pp. 128
–133
.10.2106/JBJS.H.001559.
Iorio
, R.
, Healy
, W. L.
, and Richards
, J. A.
, 1997, “Hospital Cost of Primary vs. Revision Total Hip Arthroplasty After Cost Containment
,” J. Arthroplasty
, 12
(2), pp. 227.10.1016/S0883-5403(97)90107-810.
Liang
, T. J.
, You
, M. Z.
, Xing
, P. F.
, Bin
, S.
, Ke
, Z. Z.
, and Jing
, Y.
, 2010
, “Uncemented Total Hip Arthroplasty in Patients Younger Than 50 Years: A 6- to 10-Year Follow-Up Study
,” Orthopedics
, 33
(4
), pp. 236
–239
.10.3928/01477447-20100225-1811.
Lewinnek
, G. E.
, Lewis
, J.
, Tarr
, R.
, Compere
, C.
, and Zimmerman
, J.
, 1978
, “Dislocations After Total Hip-Replacement Arthroplasties
,” J. Bone Joint Surg. Am.
, 60
(2
), pp. 217
–220
.12.
Dorr
, L. D.
, Malik
, A.
, Dastane
, M.
, and Wan
, Z.
, 2009
, “Combined Anteversion Technique for Total Hip Arthroplasty
,” Clin. Orthop. Relat. Res.
, 467
(1
), pp. 119
–127
.10.1007/s11999-008-0598-413.
Bosker
, B. H.
, Verheyen
, C. C. P. M.
, Horstmann
, W. G.
, and Tulp
, N. J. A.
, 2007
, “Poor Accuracy of Freehand Cup Positioning During Total Hip Arthroplasty
,” Arch. Orthop. Trauma Surg.
, 127
(5
), pp. 375
–379
.10.1007/s00402-007-0294-y14.
Hassan
, D. M.
, Johnston
, G. H.
, Dust
, W. N.
, Watson
, G.
, and Dolovich
, A. T.
, 1998
, “Accuracy of Intraoperative Assessment of Acetabular Prosthesis Placement
,” J. Arthroplasty
, 13
(1
), pp. 80
–84
.10.1016/S0883-5403(98)90079-115.
Marx
, A.
, von Knoch
, M.
, Pförtner
, J.
, Wiese
, M.
, and Saxler
, G.
, 2006
, “Misinterpretation of Cup Anteversion in Total Hip Arthroplasty Using Planar Radiography
,” Arch. Orthop. Trauma Surg.
, 126
(7
), pp. 487
–492
.10.1007/s00402-006-0163-016.
Ghelman
, B.
, Kepler
, C. K.
, Lyman
, S.
, and Della Valle
, A. G.
, 2009
, “CT Outperforms Radiography for Determination of Acetabular Cup Version After THA
,” Clin. Orthop. Relat. Res.
, 467
(9
), pp. 2362
–2370
.10.1007/s11999-009-0774-117.
Echeverri
, S.
, Leyvraz
, P.-F.
, Zambelli
, P.-Y.
, and Jolles
, B. M.
, 2006
, “Reliable Acetabular Cup Orientation With a New Gravity-Assisted Guidance System
,” J. Arthroplasty
, 21
(3
), pp. 413
–419
.10.1016/j.arth.2005.04.01518.
DiGioia
, A. M.
, Jaramaz
, B.
, Plakseychuk
, A. Y.
, Moody
, J. E.
, Nikou
, C.
, LaBarca
, R. S.
, Levison
, T. J.
, and Picard
, F.
, 2002
, “Comparison of a Mechanical Acetabular Alignment Guide With Computer Placement of the Socket
,” J. Arthroplasty
, 17
(3
), pp. 359
–364
.10.1054/arth.2002.3041119.
DiGioia
, A. M.
, Jaramaz
, B.
, Blackwell
, M.
, Simon
, D. A.
, Morgan
, F.
, Moody
, J. E.
, Nikou
, C.
, Colgan
, B. D.
, Aston
, C. A.
, Labarca
, R. S.
, Kischell
, E.
, and Kanade
, T.
, 1998
, “The Otto Aufranc Award. Image Guided Navigation System to Measure Intraoperatively Acetabular Implant Alignment
,” Clin. Orthop. Relat. Res.
, 355
(10
), pp. 8
–22
.10.1097/00003086-199810000-0000320.
Dorr
, L. D.
, 2006
, “Computer Navigation for Total Hip Replacement
,” Oper. Tech. Orthop.
, 16
(2
), pp. 112
–119
.10.1053/j.oto.2006.03.00921.
Ybinger
, T.
, and Kumpan
, W.
, 2007
, “Enhanced Acetabular Component Positioning Through Computer-Assisted Navigation
,” Int. Orthop.
, 31
(Suppl 1
), pp. S35
–S38
.10.1007/s00264-007-0430-x22.
Sugano
, N.
, 2013
, “Computer-Assisted Orthopaedic Surgery and Robotic Surgery in Total Hip Arthroplasty
,” Clin. Orthop. Surg.
, 5
(1
), pp. 1
–9
.10.4055/cios.2013.5.1.123.
Hananouchi
, T.
, Saito
, M.
, Koyama
, T.
, Hagio
, K.
, Murase
, T.
, Sugano
, N.
, and Yoshikawa
, H.
, 2009
, “Tailor-Made Surgical Guide Based on Rapid Prototyping Technique for Cup Insertion in Total Hip Arthroplasty
,” Int. J. Med. Robot. Comput. Assist. Surg.
, 5
(2
), pp. 164
–169
.10.1002/rcs.24324.
Buller
, L.
, Smith
, T.
, Bryan
, J.
, Klika
, A.
, Barsoum
, W.
, and Iannotti
, J. P.
, 2013
, “The Use of Patient-Specific Instrumentation Improves the Accuracy of Acetabular Component Placement
,” J. Arthroplasty
, 28
(4
), pp. 631
–636
.10.1016/j.arth.2012.12.00125.
McGovern
, T. F.
, 2011
, “Customized Patient Instrumentation for Total Knee Arthroplasty: Preoperative Planning and Intraoperative Technique
,” Am. J. Orthop.
, 40
(11 Suppl
), pp. 9
–12
.26.
Johnson
, D. R.
, 2011
, “The Benefits of Customized Patient Instrumentation to Lower-Volume Joint Replacement Surgeons: Results From Practice
,” Am. J. Orthop.
, 40
(11 Suppl
), pp. 13
–16
.27.
Small
, T.
, Krebs
, V.
, Molloy
, R.
, Bryan
, J.
, Klika
, A. K.
, and Barsoum
, W. K.
, 2013
, “Comparison of Acetabular Shell Position Using Patient Specific Instruments vs. Standard Surgical Instruments: A Randomized Clinical Trial
,” J. Arthroplasty
, 29
(5
), pp. 1030
–1037
.10.1016/j.arth.2013.10.00628.
Amuwa
, C.
, and Dorr
, L. D.
, 2008
, “The Combined Anteversion Technique for Acetabular Component Anteversion
,” J. Arthroplasty
, 23
(7
), pp. 1068
–1070
.10.1016/j.arth.2008.04.02529.
Yoshimine
, F.
, 2006
, “The Safe-Zones for Combined Cup and Neck Anteversions That Fulfill the Essential Range of Motion and Their Optimum Combination in Total Hip Replacements
,” J. Biomech.
, 39
(7
), pp. 1315
–1323
.10.1016/j.jbiomech.2005.03.00830.
Kumar
, M. A.
, Shetty
, M. S.
, Kiran
, K. G.
, and Kini
, A. R.
, 2012
, “Validation of Navigation Assisted Cup Placement in Total Hip Arthroplasty
,” Int. Orthop.
, 36
(1
), pp. 17
–22
.10.1007/s00264-011-1268-9Copyright © 2015 by ASME
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