Aims. Custom triflange acetabular components (CTACs) play an important role in reconstructive orthopaedic surgery, particularly in revision total hip arthroplasty (rTHA) and pelvic tumour resection procedures. Accurate CTAC positioning is essential to successful surgical outcomes. While prior studies have explored CTAC positioning in rTHA, research focusing on tumour cases and implant flange positioning precision remains limited. Additionally, the impact of intraoperative navigation on positioning
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 CT-based navigation for RAO to perform safe and accurate osteotomy. CT-based navigation allows precise osteotomy during surgery but cannot track the bony fragment after osteotomy. Thus, it is an issue to achieve successful reorientation in accordance with preoperative planning. In this presentation, we introduce a new method to achieve reorientation and evaluate its
The purposes of this study were to report the
The purposes of this study were to evaluate the
When treating periprosthetic femur fractures (PPFFs) around total hip arthroplasty (THA)], determining implant fixation status preoperatively is important, since this guides treatment regarding ORIF versus revision. The purpose of this study was to determine the
Aims. Hip arthroplasty aims to accurately recreate joint biomechanics. Considerable attention has been paid to vertical and horizontal offset, but femoral head centre in the anteroposterior (AP) plane has received little attention. This study investigates the
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
Pre-operative definitive diagnosis of infection in painful total hip arthroplasty (THA) is not always easy to be established, making the intra-operative decision-making process crucial in management of revision hip surgery. Calprotectin is a promising point-of-care novel biomarker that has displayed high
Aims. Accurate placement of the acetabular component during total hip
arthroplasty (THA) is an important factor in the success of the
procedure. However, the reported
Objectives. The
Introduction. Cross table lateral (CTL) radiographs are commonly used to measure acetabular component anteversion after total hip arthroplasty (THA). CTL measurements may differ by >10 degrees from CT scan measurements, but the reasons for this discrepancy are poorly understood. We compare anteversion measurements made on CTL radiographs and CT scans to identify spinopelvic parameters predictive of inaccuracy. Methods. THA patients (n=47) with preoperative spinopelvic radiographic analysis and postoperative CT scans were retrospectively reviewed. Acetabular component anteversion was measured on post-operative CTL radiographs, and CT scans using 3D reconstructions of the pelvis. Patients were grouped by error (CTL-CT)>10° (n=11) or <10° (n=36), and spinopelvic mobility parameters were compared using t-tests. Correlation between error and mobility parameters was assessed with Pearson coefficient. Results. Patients with CTL error >10° (range 10–14) had stiffer lumbar spines with less lumbar flexion (38° vs 47°, p=0.03), greater sagittal imbalance measured by pelvic incidence-lumbar lordosis mismatch (6° vs −2°, p=0.04), more pelvic extension when seated (pelvic tilt −10° vs −2°, p=0.05), and greater change in pelvic tilt between supine and seated positions (13° vs 4°, p=0.04). The error of CTL measurements showed a positive correlation with increased CTL anteversion (r=0.5, p=0.001), standing lordosis (r=0.23, p=0.05), seated lordosis (r=0.4, p=0.01) and pelvic tilt change between supine and step-up positions (r=0.34, p=0.01). Discussion. Differences in spinopelvic mobility patterns may explain the variable
Aims. Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic
Pre-operative computerised three-dimensional planning was carried out in 223 patients undergoing total hip replacement with a cementless acetabular component and a cementless modular-neck femoral stem. Components were chosen which best restored leg length and femoral offset. The post-operative restoration of the anatomy was assessed by CT and compared with the pre-operative plan. The component implanted was the same as that planned in 86% of the hips for the acetabular implant, 94% for the stem, and 93% for the neck-shaft angle. The rotational centre of the hip was restored with a mean
Introduction. Outcomes following large joint arthroplasty are influenced by the
Robotic assisted surgery aims to reduce surgical errors in implant positioning and better restore native hip biomechanics compared to conventional techniques for total hip arthroplasty (THA). The primary objective of this study was to compare
In 20 patients undergoing hybrid total hip arthroplasty, the reproducibility and
Several methods of measuring the migration of the femoral component after total hip replacement have been described, but they use different reference lines, and have differing
Cross-table lateral (CTL) radiographs are commonly used to measure acetabular component anteversion after total hip arthroplasty (THA). The CTL measurements may differ by > 10° from CT scan measurements but the reasons for this discrepancy are poorly understood. Anteversion measurements from CTL radiographs and CT scans are compared to identify spinopelvic parameters predictive of inaccuracy. THA patients (n = 47; 27 males, 20 females; mean age 62.9 years (SD 6.95)) with preoperative spinopelvic mobility, radiological analysis, and postoperative CT scans were retrospectively reviewed. Acetabular component anteversion was measured on postoperative CTL radiographs and CT scans using 3D reconstructions of the pelvis. Two cohorts were identified based on a CTL-CT error of ≥ 10° (n = 11) or < 10° (n = 36). Spinopelvic mobility parameters were compared using independent-samples Aims
Methods
We evaluated the
We report on a cadaveric study and early experience using patient specific drill guides to prevent cortex perforations and reduce the need for a trochanteric osteotomy in revision THA. Mimic software (Materialise) was used for 3D analysis of the cement mantle and cement plug. Based on the CT findings a Cannulated drill guide with the shape of the femoral stem was printed in medical graded nylon intraoperative findings and complications were recorded on videotape using a standard 5mm laparoscope for medullary inspection Surgical Technique was to attain a pre-operative CT scan with MARS protocol of the proximal femur to evaluate the femoral stem positioning, the 3D anatomy of the cement mantle, the length of the cement plug and the quality of the surrounding bone. Subsequent a 3D printing of patient specific cannulated drill guide with the shape of the removed femoral component but an eccentric cannulation was made. Endoscopic inspection was performed of the inside of the cement mantle, then insertion of the autoclaved cannulated drill guide in the existing cement mantle. After perforation of the distal plug through the PSI drill guide using either a long drill or an ultrasound plug perforation tool (Zimmer Biomet, Warsaw) the excessive cement was removed with standard available flexible femoral shaft reamers (Zimmer Biomet). Further laproscopic examination of the femoral canal performed to verify completeness of the cement removal CT scans with 3D reconstruction of the existing cement mantle is possible using Modern CT with MARS protocols. After the training on sawbones and cadaveric bones a predictable plug perforation was obtained in all clinical cases. There were no intraoperative cortex perforations and no intraoperative femoral fractures. CT scan analysis of femoral cement mantles together with patient specific drill guides are promising tools to reduce the risk of femoral perforation in revision total hip arthroplasty.Results
Conclusion