Abstract
Background
A high precision of three-dimensional (3D) computerised planning of THA was recently reported. However, there is no comparative study analysing the value of 3D planning comparatively to the planning made on X-rays using 2D templates
Material and method
A prospective comparative randomised study was carried out from 2008 to 2009, and included 2 groups of 32 patients who underwent THA for primary osteoarthritis. One surgeon performed all the procedures using a direct anterior approach. In one group, the planning was made on calibrated X-Rays using 2D templates. In the other group, a 3D planning was performed based on CT-scan using the Hip-Plan software. Post operatively, the final hip anatomy was analysed on X-Rays for the 2D group and on CT-scan for the 3D group.
Results
In the 3D group, the duration of the surgical procedure was 18% shorter and the bleeding was 34% lower. The prediction rate of the stem and the cup sizes were respectively of 100% and 97% in the 3D group. In the 2D group, these rates were 43%. When combining both components, the prediction rate was 97% in the 3D group and 16% in the 2D group. The center of rotation, the femoral off-set and the length were restored with a twice higher precision in the 3D group
Discussion
This higher precision was probably due to the accurate analysis of the hip anatomy, the problems that may be encountered were detected before surgery. Clinical benefits for the patients were also proved. This technique is now our gold standard procedure.
