scholarly journals Virtual Hip Replacement Simulator for 3D Printed Implants

2017 ◽  
Author(s):  
Neil Vaughan ◽  
Venketesh N. Dubey
Keyword(s):  
Virtual Reality ◽  
Hip Fractures ◽  
Hip Replacement ◽  
Orthopaedic Surgery ◽  
Orthopaedic Surgeons ◽  
Total Hip ◽  
Hip Replacements ◽  
3D Printed ◽  
Orthopaedic Training ◽  
The Uk

This research presents a virtual reality simulator for total hip replacement surgery. The simulator supports a library of 3D hip stem models for different sizes and manufacturers. The 3D hip stems can be adjusted in size and shape by parametric software and sent for 3D printing. Biocompatible materials such as titanium enable the 3D printed stems to be directly implanted on patients. Currently surgical simulation for orthopaedic procedures is not as advanced as other surgical disciplines. As a result there are only limited training simulators available for orthopaedic surgery such as total hip replacement, hip resurfacing or knee replacement. This is demanding since 66,000 hip replacements are performed annually in the UK. One area which is neglected in VR orthopaedic simulation is the digital library generation of implants. Currently orthopaedic surgeons have limited choice in terms of an exact identification of implant specific to patient requirements. We conducted a literature review of orthopaedic training simulators which found no simulators catering for this [9]. Orthopaedic surgeons generally have a positive opinion for the use of virtual reality (VR) training systems. A survey amongst all orthopaedic surgeons in New Zealand found that 77% of qualified surgeons believe simulation is effective for practicing and learning surgical procedures [1]. A separate review from the American Academy of Orthopaedic Surgeons (AAOS) showed that over 80% agreed that surgical skills simulations should become a required part of orthopaedic training, based on views from 185 program directors and 4549 residents. There was a strong agreement that simulation technology should be a required component of orthopaedic resident training [2]. The hip replacement procedure has been considered as the most successful and influential orthopaedic surgery of the twentieth century. Currently over 66,000 total hip replacements (THR) are performed each year in England and Wales by the National Health Service (NHS) and around 75,000 hip fractures are treated each year in the UK. Knee arthroscopy has increased 49% from 1996–2006 and now over 1 million are performed each year [3]. Each year there are an increasing number of orthopaedic procedures due to the aging population. Currently 247,000 hip fractures occur yearly in the United States, with the majority occurring in the population over 45 years old [4]. The incidence of hip fracture is also on the rise, partly due to the aging population, with over half a million hip fractures annually expected by 2040. The cost of these fractures is also expected to rise from $7 billion per year [4], to nearly $16 billion per year by 2040 [5]. Each hip fracture is estimated at costing between $39,555 and $40,600 in the first year after surgery [6]. Hip fractures have the highest cost of any orthopaedic procedure after surgery, and also incur $11,241 each year following surgery in extra health costs. Due to increased life expectancy, worldwide by 2050, it is projected that 6.26 million hip fractures will occur annually [7]. A paradigm shift is underway toward use of surgical training simulations [8]. The conventional master-apprentice learning model for surgical training of ‘see one, do one, teach one’ has recently been seen as inefficient. Due to orthopaedics being heavily dependent on technical skill, orthopaedic VR simulation holds potential to have great impact for improving surgical skill. The transition to VR simulation is relatively new compared to cadaver training which has been the gold standard for several centuries.

scholarly journals Augmented Reality, Virtual Reality and Artificial Intelligence in Orthopedic Surgery: A Systematic Review

2021 ◽  
Vol 11 (7) ◽  
pp. 3253
Author(s):  
Umile Giuseppe Longo ◽  
Sergio De Salvatore ◽  
Vincenzo Candela ◽  
Giuliano Zollo ◽  
Giovanni Calabrese ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Virtual Reality ◽  
Augmented Reality ◽  
Orthopaedic Surgery ◽  
Resident Training ◽  
Comprehensive Search ◽  
Virtual And Augmented Reality ◽  
Orthopaedic Training ◽  
Meta Analyses

Background: The application of virtual and augmented reality technologies to orthopaedic surgery training and practice aims to increase the safety and accuracy of procedures and reducing complications and costs. The purpose of this systematic review is to summarise the present literature on this topic while providing a detailed analysis of current flaws and benefits. Methods: A comprehensive search on the PubMed, Cochrane, CINAHL, and Embase database was conducted from inception to February 2021. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The Cochrane Risk of Bias Tool and the Methodological Index for Non-Randomized Studies (MINORS) was used to assess the quality and potential bias of the included randomized and non-randomized control trials, respectively. Results: Virtual reality has been proven revolutionary for both resident training and preoperative planning. Thanks to augmented reality, orthopaedic surgeons could carry out procedures faster and more accurately, improving overall safety. Artificial intelligence (AI) is a promising technology with limitless potential, but, nowadays, its use in orthopaedic surgery is limited to preoperative diagnosis. Conclusions: Extended reality technologies have the potential to reform orthopaedic training and practice, providing an opportunity for unidirectional growth towards a patient-centred approach.

Complications with the Zurich Canine Total Hip Replacement System in an Initial Series of Cases Performed by a Single Surgeon

2021 ◽  
Author(s):  
Samuel P. Franklin ◽  
Nathan A. Miller ◽  
Todd Riecks
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Weight Bearing ◽  
Normal Function ◽  
High Rate ◽  
Total Hip ◽  
Initial Series ◽  
Major Complications ◽  
Hip Replacements ◽  
Replacement System

Abstract Objective The aim of this study was to quantify the complications using the Zurich total hip replacement system in an initial series of cases performed by a single surgeon who had experience with other total hip replacement systems. Materials and Methods This was a retrospective study in which complications were classified as major if any treatment was needed or if the outcome was less than near-normal function. Complications that did not warrant treatment and that did not result in function that was inferior to near-normal were considered minor. Outcomes were assessed by radiographic review, physical examination, subjective gait evaluation or, in one case, by objective gait analysis. Bilateral total hip replacements were considered separate procedures. Results The first 21 procedures in 19 dogs performed by a single surgeon were included. The mean time to follow-up was 48 weeks (range: 8–120 weeks; standard deviation: 36 weeks). Two cases (of 21) experienced major complications including one dog with excess internal femoral rotation during weight bearing and one dog having luxation. One case (of 21) had a minor complication; femoral fracture in the presence of an intact bone plate that maintained alignment and healed without treatment. Clinical Significance A high rate of successful outcomes with few major complications can be obtained in the initial cases treated using the Zurich total hip replacement system for surgeons with prior experience with other total hip replacement systems.

scholarly journals The appropriateness of blood transfusion following primary total hip replacement

2012 ◽  
Vol 94 (3) ◽  
pp. 201-203 ◽  
Author(s):  
PJ Joy ◽  
SJ Bennet
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Orthopaedic Surgery ◽  
Significant Proportion ◽  
Study Data ◽  
Total Hip ◽  
Audit Data ◽  
Prescribing Practice ◽  
Service Data

INTRODUCTION A significant proportion of all red cell transfusions are given to patients undergoing elective orthopaedic surgery. Concern over transfusion safety and cost, coupled with evidence showing that restrictive transfusion policies benefit patients, prompted us to audit our blood prescribing practice at Gloucestershire Hospitals NHS Foundation Trust in order to assess the appropriateness of every transfusion episode following elective primary total hip replacement. METHODS All patients undergoing a primary total hip replacement in our department over a six-month period were included in the study. Data were collected retrospectively using case note examination and transfusion service data. Standards were dictated by the British Orthopaedic Association guidelines on blood conservation in elective orthopaedic surgery. RESULTS Twenty-seven per cent of patients (39/143) were transfused. Forty-six per cent of these (18/39) were transfused inappropriately and twenty-three per cent (9/39) appropriately. Thirteen per cent (5/39) had a valid indication for transfusion but were over-transfused and in eighteen per cent (7/39) the quality of documentation did not allow an assessment to be made. Fifty-two per cent of patients who had surgical drains (29/56) were transfused. Reaudit following staff education and amendments to the local transfusion policy did not demonstrate a reduction in transfusion rates. CONCLUSIONS This audit showed that significant potential exists for reducing transfusion rates based on optimising prescribing practice alone. It also demonstrated that changing local practice based on audit data can be challenging.

scholarly journals Total Hip Replacement: Results of a Postal Survey of Current Practice on the Cement Fixation of the Acetabular Cup in the UK

2004 ◽  
Vol 14 (3) ◽  
pp. 155-162
Author(s):  
R. Mootanah ◽  
P. Ingle ◽  
K. Cheah ◽  
J. K. Dowell ◽  
J. C. Shelton
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Current Practice ◽  
Postal Survey ◽  
Acetabular Cup ◽  
Total Hip ◽  
The Uk

The complex primary total hip replacement

2011 ◽  
Author(s):  
James Donaldson ◽  
Richard Carrington
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Walking Ability ◽  
Careful Evaluation ◽  
Screening Programs ◽  
Total Hip ◽  
Number Of Patients ◽  
Hip Replacements

♦ Hip Dysplasia• Despite screening programs, a large number of patients are affected by dysplastic hips and their sequelae• An understanding of anatomical abnormalities is crucial• Appropriate techniques and implants make arthroplasty feasible• Complications are significantly higher than standard primary hip replacements♦ Protrusio Acetabuli• Technical difficulties include inadequate medial wall and restoring offset, hip centre and leg lengths• Neck may need to be cut in-situ; bone graft is usually necessary and ideally should be taken from the femoral head• Antiprotrusio cages or custom implants may be needed in cases with excessive bone loss♦ Arthrodesed hip to total hip replacement• Careful evaluation of the gluteal muscles is mandatory and predicts final walking ability and patient satisfaction• Long-term effectiveness of total hip replacement in ankylosed hips is satisfactory but there is a higher complication rate

scholarly journals 130 Impact of Balance Training in Virtual Reality on Body Balance in Patients after Total HIP Replacement

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Anna Hadamus ◽  
Dariusz Białoszewski ◽  
Aleksandra Justyna Kowalska ◽  
Edyta Urbaniak ◽  
Rafał Boratyński ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Control Group ◽  
Forward Movement ◽  
Body Balance ◽  
Total Hip ◽  
Vr Training ◽  
The Impact ◽  
Experimental Group

Abstract Introduction Virtual Reality (VR) training is becoming an increasingly popular form of exercise aiding in re-education of body balance. Many reports have demonstrated its effectiveness, greater patient involvement in exercise and better outcomes compared to traditional rehabilitation [1]. The aim of this study was to assess the impact of the additional training in VR on body balance in patients after total hip replacement. Material and Methods 56 patients randomly assigned to an experimental group (30 people) and a control group (26 people) was included in the study. All patients had undergone THR within 2 to 12 weeks before the beginning of the study. The control group underwent standard post-operative rehabilitation, while a VR training programme was used in the experimental group as an additional rehabilitation tool. Balance was assessed with the VBC system and the AMTi AccuSway plate. The results were considered significant for p <0.05. Results CoP displacement in the frontal plane was reduced in both groups in tests with eyes closed (p<0.05). Other parameters in standing tests remain the same. The maximum forward deflection test has shown a significant increase in the range of forward movement in the experimental group (p <0.05). In the control group, the duration of the forward movement phase was reduced, but the range remained the same. The rhythmic sway test showed an increase in the average speed of movements in the experimental group (p <0.05). There were no changes in the control group. Conclusions 1. Postural stability training in VR primarily involves dynamic aspects of the maintenance of balance. 2. Improvement in functional tests may indicate a better clinical outcome of rehabilitation in patients who have additionally trained in VR. 3. The improvement obtained in static tests most probably results from improvement in muscle strength and static stability resulting from the rehabilitation.

Nice Hips: Shame about the Conclusions

2002 ◽  
Vol 12 (3) ◽  
pp. 334-337 ◽  
Author(s):  
A.D. Toms ◽  
M. Jiggins ◽  
G. Prosser ◽  
E.S. Isbister
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Clinical Excellence ◽  
Appraisal Committee ◽  
Orthopaedic Surgeons ◽  
Total Hip ◽  
Selection Of

In April 2000 the National Institute for Clinical Excellence (NICE) issued their first appraisal in the field of surgery, “Guidance on the selection of prostheses for primary total hip replacement”. NICE has already been heavily criticised for its recommendations in the field of medicine, due to its perceived role in rationing healthcare. This paper examines the conclusions of the appraisal committee (which included only two orthopaedic surgeons), the evidence on which they drew their conclusions and the evidence that was overlooked. We conclude that it is not clear how they determined the important ten-year benchmark and that they over-emphasise the benefits of cheaper cemented prostheses, failing to fully consider the evidence for the more expensive uncemented and hybrid combinations.

THREE-DIMENSIONAL MORPHOMETRY OF NATIVE ACETABULUM IN RELATION TO DESIGN AND IMPLANTATION OF CANINE TOTAL HIP REPLACEMENTS

2012 ◽  
Vol 24 (06) ◽  
pp. 549-555 ◽  
Author(s):  
Ching-Ho Wu ◽  
Cheng-Chung Lin ◽  
Tung-Wu Lu ◽  
Lih-Seng Yeh
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Quantitative Data ◽  
Three Dimensional ◽  
Morphological Parameters ◽  
3D Ct ◽  
Total Hip ◽  
Acetabular Orientation ◽  
Total Hip Replacements ◽  
Hip Replacements

Total hip replacement (THR) has been one of the main choices in treating dysplasia and other disabling conditions of the coxofemoral joint of large-breed dogs. Quantitative data of the three-dimensional (3D) morphology of the native normal acetabulum will be helpful for better design and implantation of prosthetic components. However, 3D orientation and morphological parameters of the native acetabulum in large-breed dogs are rarely reported. The purposes of the study were to measure the values of the 3D morphological parameters of the native acetabulum in Labrador Retriever dogs, namely acetabular orientation in relation to the pelvis, as well as the radius, angle between ventral and dorsal rims, and the distance from the center to the dorsal rim of the acetabulum using a 3D CT-derived model. The data will be useful for developing a more accurate guideline for improving current THR designs and for more accurate placement of the acetabulum component during THR surgery.

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