Advanced 3D imaging and
Abstract. Purpose. Intracanal rib head penetration is a well-known entity in dystrophic scoliotic curves in neurofibromatosis type 1. There is potential for spinal cord injury if this is not recognised and managed appropriately. No current
Rotational acetabular osteotomy (RAO), one of periacetabular osteotomies, is an effective joint-preserving surgical treatment for developmental dysplasia of the hip. Since 2013, we have been using a
Background. Accurate acetabular cup positioning is considered to be essential to prevent postoperative dislocation and improve the long-term outcome of total hip arthroplasty (THA). Recently various devices such as navigation systems and patient-specific guides have been used to ensure the accuracy of acetabular cup positioning. Objectives. The present study evaluated the usefulness of
Aims. This prospective randomised controlled trial was designed to
evaluate the outcome of both the MRI- and
Accurate cup placement in total hip arthroplasty (THA) for the patients with developmental dysplasia of the hip (DDH) is one of the challenges due to distinctive bone deformity. Robotic-arm assisted system have been developed to improve the accuracy of implant placement. This study aimed to compare the accuracy of robotic-arm assisted (Robo-THA),
Aims. Dislocation of the hip remains a major complication after periacetabular tumour resection and endoprosthetic reconstruction. The position of the acetabular component is an important modifiable factor for surgeons in determining the risk of postoperative dislocation. We investigated the significance of horizontal, vertical, and sagittal displacement of the hip centre of rotation (COR) on postoperative dislocation using a
Aims. Type 2 diabetes mellitus (T2DM) impairs bone strength and is a significant risk factor for hip fracture, yet currently there is no reliable tool to assess this risk. Most risk stratification methods rely on bone mineral density, which is not impaired by diabetes, rendering current tests ineffective.
Total hip arthroplasty (THA) is one of the most successful surgical procedures of modern times, however debate continues as to the optimal orientation of the acetabular component and how to reliably achieve this. We hypothesised that functional
Introduction. Total Knee Arthroplasty (TKA) is highly successful in treatment of end-stage degenerative arthritis of the knee.
Introduction. Robotic-assisted hip arthroplasty helps acetabular preparation and implantation with the assistance of a robotic arm. A computed tomography (CT)-based navigation system is also helpful for acetabular preparation and implantation, however, there is no report to compare these methods. The purpose of this study is to compare the acetabular cup position between the assistance of the robotic arm and the
Introduction:. Since2007, we have used
We compared the alignment of 39 total knee replacements implanted using the conventional alignment guide system with 37 implanted using a
Introduction. Orientation of the acetabular component in total hip arthroplasty has been shown to influence component wear, stability, and impingement. Freehand placement of the component can lead to widely variable radiographic outcomes. Accurate abduction, in particular, can be difficult in the lateral decubitus position due to limited ability to appreciate and control positional obliquity of the pelvis. A
Introduction. Surgeons fixing scaphoid fractures need to be familiar with its morphological variations and their implications on safe screw placement during fixation of these fractures. Literature has limited data in this regard. The purpose of this
Background. Accuracy of implantation is a recognized prognostic factor for the long-term survival of TKA. The purpose of this study was to analyze the accuracy of component orientation and post-operative alignment of the leg following
Acetabular component malpositioning increases the risk of impingement, dislocation, and wear. The goal of computer-assisted techniques is to improve the accuracy of component positioning, in particular optimizing the orientation of the acetabular cup. The goal of the current study was to measure accuracy of cup placement in a large clinical series of hips that underwent
Introduction and Objective. The aim of this study was to evaluate whether
Introduction. Since2007, we have used
Ideally the hip arthroplasty should not be subject to bony or prosthetic impingement, in order to minimise complications and optimise outcomes. Modern 3d planning permits pre-operative simulation of the movements of the planned hip arthroplasty to check for such impingement. For this to be meaningful, however, it is necessary to know the range of movement (ROM) that should be simulated. Arbitrary “normal” values for hip ROM are of limited value in such simulations: it is well known that hip ROM is individualised for each patient. We have therefore developed a method to determine this individualised ROM using CT scans. CT scans were performed on 14 cadaveric hips, and the images were segmented to create 3d virtual models. Using Matlab software, each virtual hip was moved in all potential directions to the point of bony impingement, thus defining an individualised impingement-free 3d ROM envelope. This was then compared with the actual ROM as directly measured from each cadaver using a high-resolution motion capture system. For each hip, the ROM envelope free of bony impingement could be described from the CT and represented as a 3d shape. As expected, the directly measured ROM from the cadaver study for each hip was smaller than the
Accurate evaluation of lower limb coronal alignment is essential for effective pre-operative planning of knee arthroplasty. Weightbearing hip-knee-ankle (HKA) radiographs are considered the gold standard. Mako SmartRobotics uses
Patella resection has been the least controlled element of total knee arthroplasty (TKA). We have developed an intraoperative guide system involving a custom-made surgical template designed on the basis of a three-dimensional computer simulation incorporating computed tomography (CT) data for several years. This time we have applied this intraoperative guide system for the patella resection in TKA. We investigated the accuracy of
Introduction.
Introduction: Preoperative planning is an important part of the total knee arthroplasty(TKA) surgical procedure. In joint arthroplasty, the use of a templating system has been recommended and it is routinely used with most designs. The aim of this study was to compare the accuracy of preoperative templating in TKA between conventional two-dimensional (2D) and computed tomography (CT)-based 3D procedures in order to confirm the necessity of using 3D evaluations for preoperative planning. Method: One-hundred consecutive primary TKAs performed during the period between December 2005 and May 2009 were analyzed. The mean age of the patients was 73.3 years (range, 33 to 90 years). Preoperative templating was performed for each TKA using both conventional 2D radiographs (both anteroposterior and lateral views) which were analyzed by a single senior surgeon. Preoperative CT scans of the knee were performed and a
Introduction:. Alignment of the initial femoral guidewire is critical in avoiding technical errors that may increase the risk of failure of the femoral component. A novel alternative to conventional instrumentation for femoral guidewire insertion is a computed tomography (CT) based alignment guide. The aim of this study was to assess the accuracy of femoral component alignment using a
Objectives. Few reports were shown about the position of the cup in total hip arthroplasty (THA) with
Image-guided TKR requires a three-dimensional model of the patient, traditionally provided by preoperative CT scans. Recent developments have focused on navigation systems that eliminate the need for preoperative CT scan. This paper aims to assess the comparative accuracy of prosthesis planning using
Objectives. This study aims to assess the correlation of
Introduction and Objective. In recent years, along with the extending longevity of patients and the increase in their functional demands, the number of annually performed RSA and the incidence of complications are also increasing. When a complication occurs, the patient often needs multiple surgeries to restore the function of the upper limb. Revision implants are directly responsible for the critical reduction of the bone stock, especially in the shoulder. The purpose of this paper is to report the use of allograft bone to restore the bone stock of the glenoid in the treatment of an aseptic glenoid component loosening after a reverse shoulder arthroplasty (RSA). Materials and Methods. An 86-years-old man came to our attention for aseptic glenoid component loosening after RSA. Plain radiographs showed a complete dislocation of the glenoid component with 2 broken screws in the neck of glenoid. CT scans confirmed the severe reduction of the glenoid bone stock and critical bone resorption and were used for the preoperative planning. To our opinion, given the critical bone defect, the only viable option was revision surgery with restoration of bone stock. We planned to use a bone graft harvested from distal bone bank femur as component augmentation. During the revision procedure the baseplate with a long central peg was implanted “on table” on the allograft and an appropriate osteotomy was made to customize the allograft on the glenoid defect according to the
The aim of this study was to investigate the association between fracture displacement and survivorship of the native hip joint without conversion to a total hip arthroplasty (THA), and to determine predictors for conversion to THA in patients treated nonoperatively for acetabular fractures. A multicentre cross-sectional study was performed in 170 patients who were treated nonoperatively for an acetabular fracture in three level 1 trauma centres. Using the post-injury diagnostic CT scan, the maximum gap and step-off values in the weightbearing dome were digitally measured by two trauma surgeons. Native hip survival was reported using Kaplan-Meier curves. Predictors for conversion to THA were determined using Cox regression analysis.Aims
Methods
Objectives. Few reports were shown about the position of the cup in total hip arthroplasty (THA) with
Background.
We have used
The present IRB approved study evaluates the early results of 100 TKAs using
The present IRB approved study evaluates the early results of 100 TKAs using
Hardware in or about the knee joint presents a number of challenges to the surgeon in performance of Total Knee Arthroplasty (TKA). Conventional instrumentation usually requires a modification of technique or removal of the metallic implants. Computer-Assisted TKA (CAOS) is another option, but adds complexity and time to the procedure. MRI-based Patient-Specific Instrumentation (PSI) cannot be used as metal causes unwanted artifact and renders the images for planning, useless. However, CT scans are not affected by metal and thus
Hardware in or about the knee joint presents a number of challenges to the surgeon in performance of Total Knee Arthroplasty (TKA). Conventional instrumentation usually requires a modification of technique or removal of the metallic implants. Computer-Assisted TKA (CAOS) is another option, but adds complexity and time to the procedure. MRI-based Patient-Specific Instrumentation (PSI) cannot be used as metal causes unwanted artifact and renders the images for planning, useless. However, CT scans are not affected by metal and thus
Aims: Various studies could show that computer assisted pedicle screw insertion can reduce pedicle perforation rate. We conducted this study to verify if pedicle screw navigation can also avoid neurological complications. Methods: Within 20 months 112 patients were stabilised with 584 pedicle screws in the thoracolumbar spine (Th1-L5). 333 screws were inserted using a
Achieving accurate implant positioning and restoring native hip biomechanics are key surgeon-controlled technical objectives in total hip arthroplasty (THA). The primary objective of this study was to compare the reproducibility of the planned preoperative centre of hip rotation (COR) in patients undergoing robotic arm-assisted THA versus conventional THA. This prospective randomized controlled trial (RCT) included 60 patients with symptomatic hip osteoarthritis undergoing conventional THA (CO THA) versus robotic arm-assisted THA (RO THA). Patients in both arms underwent pre- and postoperative CT scans, and a patient-specific plan was created using the robotic software. The COR, combined offset, acetabular orientation, and leg length discrepancy were measured on the pre- and postoperative CT scanogram at six weeks following surgery.Aims
Methods
Summary Statement. The current study introduced the effects of projection errors on ankle morphological measurements using
Introduction. Computed tomography (CT) can be utilized to design patient specific instruments (PSI) for total knee arthroplasty (TKA). The PSI preoperative plans predict bone resection, anterior-posterior implant position, implant rotation and implant size. The purpose of this study was to compare preoperatively predicted implant sizes (tibia and femur) to the actual implanted sizes. Data were compiled from two surgeons, one in the United Kingdom (Surgeon 1, cruciate retaining) and one in the United States (Surgeon 2, posterior stabilizing). Both used the same primary TKA implant systems (Sigma® and Attune®; DePuySynthes®, Warsaw, Indiana). This is the largest comparison of
INTRODUCTION Assessing femoral head coverage is a crucial element in acetabular surgery for hip dysplasia. CT has proven to be more accurate, practical and informative than plain radiography at analysing hip geometry. Klaue et al first used a computer-assisted model to indirectly derive representations of femoral head coverage. Jansen et al then described a
Objectives. The setting angle of the cup is important for achieving the stability and avoiding the dislocation after total hip arthroplasty (THA). It is difficult to set the cup at correct angle in minimally invasive THA by modified Watson-Jones approach. So we use
Introduction. We have used
Purpose. Computer navigation for hip resurfacing has been shown to reduce the incidence of technical error during femoral head preparation and provides increased accuracy compared to conventional instrumentation for insertion of the initial femoral guidewire. Limitations to the widespread use of navigation in hip resurfacing include access and cost. A novel, patient specific nylon jig has been developed as a cost effective alternative for placement of the initial guidewire. The purpose of this study was to compare the accuracy of femoral guidewire insertion between imageless navigation, conventional instrumentation and a new type of
Accurate detection of migration of hip arthroplasty stems without the burden of bone markers and stereo-radiographic equipment is of interest. This would facilitate the study of stem migration in an experimental setting, but more importantly, it would allow assessing stem loosening in patients with a painful hip outside a study protocol. We developed and validated a marker-free automated
Puropose. Three-dimensional (3D) templating based on computed tomography (CT) in total hip arthroplasty improves the accuracy of implant size. However, even when using 3D-CT preoperative planning, getting the concordance rate between planned and actual sizes to reach 100% is not easy. To increase the concordance rate, it is important to analyze the causes of mismatch; however, no such studies have been reported. This study had the following two purposes: to clarify the concordance rate in implant size between 3D-CT preoperative planning and actual size; and to analyze risk factors for mismatch. Materials and Methods. A single surgeon performed 149 THAs using Trident Cup and Centpillar Stem (Stryker) with
Purpose: Minimally invasive surgery (MIS) total knee arthroplasty (TKA) makes faster rehabilitation in many cases, but it was sometimes difficult to performed the precise osteotomy and place the implants correctly due to loss of view or orientation for its small exposure. The computer-assisted navigation TKA system (CAS) was reported to achieve the optimal alignment and placement. However, it had disadvantages of longer operation time and wider exposure to acquire the reference points than these of the conventional method. Now MIS technique needs the accuracy of implant placement, on the other hand, CAS needs less-invasive methods. Among CAS methods,
Cup orientation of total hip arthroplasty (THA) is critical for dislocation, range of motion, polyethylene wear, pelvic osteolysis, and component migration. But, substantial error under manual technique has been reported. Therefore, various navigation systems were introduced to reduce outliers. CT based navigation (CTN) was reported to reduce outliers in cup orientation. Recently, a noble technique, fluoroscopy-CT-based navigation (FCTN), has recently been developed using 2D-3D matching technique. Because of much less registration points, FCTN might be friendly to MIS THA and cases with sever bone deformity. Between October 2006 and April 2008, 33 THAs were performed through MIS approach with navigations. We prospectively randomized those into two groups, CTN and FCTN groups. We implanted cementless hemispherical cups in 18 hips using CTN (VectorVision CT Hip 3.1) and in 15 hips using FCTN (VectorVision CT Hip 3.5). For all the patients, volumetric post-operative CT scan was performed to measure 3D cup orientation. using 3D image-processing software (JMM, Japan). The difference from target angles of anteversion was 2.7 ± 2.4 degrees in FCTN group, and 12.1 ± 5.7 degrees in CTN group (p <
0.001). The absolute value of difference from target angles of inclination was 2.7 ± 2.4 degrees in FCTN group, and 6.5 ± 4.5 degrees in CTN group (p = 0.006). FCTN does not need surface registration around acetabulum, which is great advantage to MIS THA. Our study clearly showed that FCTN significantly improved a cup orientation to CTN.
Objectives. Many reports were shown about the angle of the cup in total hip arthroplasty (THA) with