scholarly journals A Comparative Study of Patients' Subjective Feelings Toward Total Hip Arthroplasty with Patient‐Specific Instruments and Traditional Total Hip Arthroplasty

2020 ◽  
Vol 12 (1) ◽  
pp. 269-276
Author(s):  
Qi‐qi Xing ◽  
Da Zhong ◽  
Yi‐xiao Pan ◽  
Sen‐bo An ◽  
Cheng‐gong Wang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Comparative Study ◽  
Hip Arthroplasty ◽  
Patient Specific ◽  
Total Hip ◽  
Patient Specific Instruments

Design considerations for patient-specific surgical templates for total hip arthroplasty with respect to acetabular cartilage

2017 ◽  
Vol 62 (3) ◽  
Author(s):  
Samuel Mueller ◽  
Intsar Ahmad ◽  
Manuel Kraemer ◽  
Michael Utz ◽  
Johannes Gaa ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Image Data ◽  
Imaging Systems ◽  
Patient Specific ◽  
Use Case ◽  
Acetabular Cartilage ◽  
Total Hip ◽  
Patient Specific Instruments ◽  
Surgical Templates

AbstractPatient-specific instruments (PSIs) are clinically used to support the surgeon during a planned intervention. The planning is typically done based on volumetric image data from medical imaging systems, e.g. computed tomography (CT). The PSI uses the known surface structure of a bone for orientation during the intervention. Some surfaces of human bone are covered with a layer of cartilage which is hardly visible in clinically applied CT-imaging. This experimental study investigates ten different PSI designs and their effect to the overall accuracy when neglecting the cartilage in the design process. Therefore, a model of an acetabulum is used to simulate the use case of PSI in total hip arthroplasty. The concept of the different designs is to create structural elasticities in the PSI to avoid shifting of the whole instrument and rather have a small part of it deformed by cartilage. A needle array structure, for instance, should also be able to oust or penetrate remaining soft tissue in the acetabulum.

Patient-Specific Guides for Total Hip Arthroplasty: A Paired Acetabular and Femoral Implantation Approach

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Jacob Stegman ◽  
Chris Casstevens ◽  
Todd Kelley ◽  
Vasile Nistor
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Geometry ◽  
Patient Specific ◽  
Total Hip ◽  
Orthopedic Procedure ◽  
Accuracy And Precision ◽  
Patient Specific Instruments ◽  
3D Printed ◽  
Ct Data

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.

Redesign of the Femoral Stem for a Total Hip Arthroplasty for Additive Manufacturing

2018 ◽  
Author(s):  
Bradley Hanks ◽  
Shantanab Dinda ◽  
Sanjay Joshi
Keyword(s):  
Additive Manufacturing ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lattice Structure ◽  
Stress Shielding ◽  
Patient Specific ◽  
Hip Implants ◽  
Hip Implant ◽  
Total Hip ◽  
Multiple Materials

Total hip arthroplasty (THA) is an increasingly common procedure that replaces all or part of the hip joint. The average age of patients is decreasing, which in turn increases the need for more durable implants. Revisions in hip implants are frequently caused by three primary issues: femoral loading, poor fixation, and stress shielding. First, as the age of hip implant patients decreases, the hip implants are seeing increased loading, beyond what they were traditionally designed for. Second, traditional implants may have roughened surfaces but are not fully porous which would allow bone to grow in and through the implant. Third, traditional implants are too stiff, causing more load to be carried by the implant and shielding the bone from stress. Ultimately this stress shielding leads to bone resorption and implant loosening. Additive manufacturing (AM) presents a unique opportunity for enhanced performance by allowing for personalized medicine and increased functionality through geometrically complex parts. Much research has been devoted to how AM can be used to improve surgical implants through lattice structures. To date, the authors have found no studies that have performed a complete 3D lattice structure optimization in patient specific anatomy. This paper discusses the general design of an AM hip implant that is personalized for patient specific anatomy and proposes a workflow for optimizing a lattice structure within the implant. Using this design workflow, several lattice structured AM hip implants of various unit cell types are optimized. A solid hip implant is compared against the optimized hip implants. It appears the AM hip implant with a tetra lattice outperforms the other implant by reducing stiffness and allowing for greater bone ingrowth. Ultimately it was found that AM software still has many limitations associated with attempting complex optimizations with multiple materials in patient specific anatomy. Though software limitations prevented a full 3D optimization in patient specific anatomy, the challenges associated such an approach and limitations of the current software are discussed.

Risk Factors for Periprosthetic Femoral Fracture in Non-cemented Total Hip Arthroplasty Through the Direct Anterior Approach

2021 ◽  
pp. 155633162110508
Author(s):  
Zachary Berliner ◽  
Cameron Yau ◽  
Kenneth Jahng ◽  
Marcel A. Bas ◽  
H. John Cooper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Parkinson Disease ◽  
Hip Arthroplasty ◽  
Femoral Fracture ◽  
Categorical Variables ◽  
Patient Specific ◽  
Periprosthetic Femoral Fracture ◽  
Total Hip ◽  
Increased Risk

Background: Although total hip arthroplasty (THA) performed through the direct anterior (DA) approach is frequently marketed as superior to other approaches, there are concerns about increased risks of intraoperative and early postoperative femoral fracture. Purpose: We sought to assess patient-specific and radiographic risk factors for intraoperative and early postoperative (90-day) periprosthetic femoral fracture (PPFx) following DA approach THA. Methods: We retrospectively reviewed 1107 consecutive, primary, non-cemented DA THAs, performed between April 2009 and January 2015, for intraoperative and early postoperative PPFx. Patients lost to follow-up before 90 days (63), cemented or hybrid THA (52), or early femoral failure for another indication (3) were excluded, yielding 989 hips for analysis. Demographic variables and patient comorbidities were analyzed as risk factors for PPFx. Continuous variables were initially compared with 1-way analysis of variance (ANOVA) and categorical variables with chi-square test. A demographic matched-paired radiographic analysis was performed for femoral stem canal fill and compared using univariate logistic regression. Results: The incidence of perioperative PPFx was 2.02%, including 10 intraoperative and 10 early postoperative fractures. Sustaining a postoperative PPFx was associated with being 70 years old or older with a body mass index (BMI) of less than 25, or with having either osteoporosis or Parkinson disease. Radiographs demonstrated that intraoperative PPFx was associated with stems that filled greater proximally rather than distally. Conclusion: Our cohort study found older age, age over 70 with BMI of less than 25, osteoporosis, and Parkinson disease were associated with increased risk for early postoperative PPFx following DA approach THA. Intraoperative fractures may occur with disproportionate proximal femoral canal fill. Further study can evaluate whether cemented femoral components may mitigate risk in these patient populations.

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