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Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_3 | Pages 13 - 13
1 Jan 2016
PRE-OPERATIVE THREE-DIMENSIONAL PLANNING OF TOTAL HIP ARTHROPLASTY BASED ON BIPLANAR LOW DOSE RADIOGRAPHS: ACCURACY AND REPRODUCIBILITY FOR A SET OF 31 PATIENTS
Mainard D Barbier O Gross J Galois L Mainard-Simard L
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Introduction

For preoperative planning of Total Hip Arthroplasty (THA) it is paramount to choose the correct implant size to avoid subsidence with too small a component or fracture with too large a component. This planning can be done either in 2D or 3D. 2D templating from X-rays frontal images remains the gold standard technique in THA preoperative planning despite the lower accuracy with uncemented components. 3D planning techniques require a CT-Scan examination overexposing patients to radiation. Biplanar EOS® radiographs are an alternative to obtain bone 3D reconstructions with a very low dose of radiation. The objective of this study was to evaluate the accuracy and reproducibility a novel 3D technique for THA preoperative planning based on biplanar low-dose radiographs.

Materials and methods

31 patients (20 women, 11 men, average age 66.1 y/o) who underwent a primary THA (Hardinge anterolateral approach) were included. Two senior orthopedic surgeons (Op_1 and Op_2) performed the pre-operative planning: (1) In 2D superimposing templates of the cup and the stem on CR radiographs. The CR images had a magnification coefficient of 1.15. (2) In 3D using dedicated hipEOS (EOS Imaging, France) software. 2D planning was performed once by each operator, 3D planning twice.

3D planning with hipEOS [Figure 1] was performed by importing 3D models of the stem and cup and superimposing them on frontal-lateral EOS® radiographs. This software proposes an initial estimate of the components size and position. If necessary, the user can correct the size of the stem and perform translations and rotations of the 3D models in order to correct the position, while clinical parameters such as the cup anteversion and inclination, as well as the femoral offset and leg length are automatically recalculated.

To evaluate the accuracy, we have compared the 2D and 3D planning with respect to the actual size implanted during the surgery. To evaluate reproducibility we have calculated the Intra-class Correlation Coefficient (ICC) of both techniques.

Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_IV | Pages 520 - 520
1 Nov 2011
167. REVIEW AND CRITICAL ANALYSIS OF A SERIES OF PRIMARY OR RECURRENT EXTRA-ABDOMINAL DESMOIDS FIBROMAS: 26 CASES
Barbier O Anract P Pluot E Larouserie F Babinet A Tomeno B
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Purpose of the study: Extra-abdominal desmoids tumours are benign tumours generally managed by more or less wide surgical resection. This surgery can be mutilating and carries a risk of recurrence to the order of 50% according to several authors.

Material and methods: We followed a series of 26 patients from 1989 to 2009 with non-operated extra-abdominal desmoids tumours. Our objective was to study the clinical, radiographic and pathological course of these tumours and identify prognostic factors. For 11 patients, no medical or surgical treatment was delivered beyond the diagnostic biopsy; for 15, the tumour recurred after surgery and no other adjuvant treatment was given.

Results: Twenty-four tumours stabilised at 13.2 months on average for primary tumours and 20.9 for recurrent tumours. Thus en general, the tumour progression was less than 3 years. In all cases, once the tumour stopped progressing, it did not progress again. One primary tumour regressed spontaneously and one recurrence continued to progress at last follow-up of 23 months. Surgery was not required for any of the patients, excepting biopsy procedures to confirm diagnosis. MRI was the exploration of choice for follow-up.

Discussion: This series, which is the largest devoted to followed extra-abdominal desmoid fibromas, confirms recent data in the literature. A wait-and-see attitude should always be discussed with this type of tumour.