The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological Evaluation
The functional positioning of components in a total hip arthroplasty (THA) and its relationship with individual lumbopelvic kinematics and a patient’s anatomy are being extensively studied. Patient-specific kinematic planning could be a game-changer; however, it should be accurately delivered intrao...
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| Format: | Article |
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MDPI AG
2021-06-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/21/12/4232 |
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| author | Andrea Ferretti Ferdinando Iannotti Lorenzo Proietti Carlo Massafra Attilio Speranza Andrea Laghi Raffaele Iorio |
| author_facet | Andrea Ferretti Ferdinando Iannotti Lorenzo Proietti Carlo Massafra Attilio Speranza Andrea Laghi Raffaele Iorio |
| author_sort | Andrea Ferretti |
| collection | DOAJ |
| description | The functional positioning of components in a total hip arthroplasty (THA) and its relationship with individual lumbopelvic kinematics and a patient’s anatomy are being extensively studied. Patient-specific kinematic planning could be a game-changer; however, it should be accurately delivered intraoperatively. The main purpose of this study was to verify the reliability and accuracy of a patient-specific instrumentation (PSI) and laser-guided technique to replicate preoperative dynamic planning. Thirty-six patients were prospectively enrolled and received dynamic hip preoperative planning based on three functional lateral spinopelvic X-rays and a low dose CT scan. Three-dimensional (3D) printed PSI guides and laser-guided instrumentation were used intraoperatively. The orientation of the components, osteotomy level and change in hip length and offset were measured on postoperative CT scans and compared with the planned preoperative values. The length of surgery was compared with that of a matched group of thirty-six patients who underwent a conventional THA. The mean absolute deviation from the planned inclination and anteversion was 3.9° and 4.4°, respectively. In 92% of cases, both the inclination and anteversion were within +/− 10° of the planned values. Regarding the osteotomy level, offset change and limb length change, the mean deviation was, respectively, 1.6 mm, 2.6 mm and 2 mm. No statistically significant difference was detected when comparing the planned values with the achieved values. The mean surgical time was 71.4 min in the PSI group and 60.4 min in the conventional THA group (<i>p</i> < 0.05). Patient-specific and laser-guided instrumentation is safe and accurately reproduces dynamic planning in terms of the orientation of the components, osteotomy level, leg length and offset. Moreover, the increase in surgical time is negligible. |
| first_indexed | 2024-03-10T10:13:17Z |
| format | Article |
| id | doaj.art-092049fee13148c2bc38b0bffe257544 |
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| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-10T10:13:17Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-092049fee13148c2bc38b0bffe2575442023-11-22T00:57:45ZengMDPI AGSensors1424-82202021-06-012112423210.3390/s21124232The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological EvaluationAndrea Ferretti0Ferdinando Iannotti1Lorenzo Proietti2Carlo Massafra3Attilio Speranza4Andrea Laghi5Raffaele Iorio6Orthopaedic and Traumatology Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyOrthopaedic and Traumatology Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyOrthopaedic and Traumatology Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyOrthopaedic and Traumatology Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyOrthopaedic and Traumatology Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDepartment of Radiology, Sant’Andrea Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyOrthopaedic and Traumatology Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyThe functional positioning of components in a total hip arthroplasty (THA) and its relationship with individual lumbopelvic kinematics and a patient’s anatomy are being extensively studied. Patient-specific kinematic planning could be a game-changer; however, it should be accurately delivered intraoperatively. The main purpose of this study was to verify the reliability and accuracy of a patient-specific instrumentation (PSI) and laser-guided technique to replicate preoperative dynamic planning. Thirty-six patients were prospectively enrolled and received dynamic hip preoperative planning based on three functional lateral spinopelvic X-rays and a low dose CT scan. Three-dimensional (3D) printed PSI guides and laser-guided instrumentation were used intraoperatively. The orientation of the components, osteotomy level and change in hip length and offset were measured on postoperative CT scans and compared with the planned preoperative values. The length of surgery was compared with that of a matched group of thirty-six patients who underwent a conventional THA. The mean absolute deviation from the planned inclination and anteversion was 3.9° and 4.4°, respectively. In 92% of cases, both the inclination and anteversion were within +/− 10° of the planned values. Regarding the osteotomy level, offset change and limb length change, the mean deviation was, respectively, 1.6 mm, 2.6 mm and 2 mm. No statistically significant difference was detected when comparing the planned values with the achieved values. The mean surgical time was 71.4 min in the PSI group and 60.4 min in the conventional THA group (<i>p</i> < 0.05). Patient-specific and laser-guided instrumentation is safe and accurately reproduces dynamic planning in terms of the orientation of the components, osteotomy level, leg length and offset. Moreover, the increase in surgical time is negligible.https://www.mdpi.com/1424-8220/21/12/4232PSITHApatient-specific dynamic planningspinopelvic kinematicpelvic tiltfunctional orientation of components |
| spellingShingle | Andrea Ferretti Ferdinando Iannotti Lorenzo Proietti Carlo Massafra Attilio Speranza Andrea Laghi Raffaele Iorio The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological Evaluation Sensors PSI THA patient-specific dynamic planning spinopelvic kinematic pelvic tilt functional orientation of components |
| title | The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological Evaluation |
| title_full | The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological Evaluation |
| title_fullStr | The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological Evaluation |
| title_full_unstemmed | The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological Evaluation |
| title_short | The Accuracy of Patient-Specific Instrumentation with Laser Guidance in a Dynamic Total Hip Arthroplasty: A Radiological Evaluation |
| title_sort | accuracy of patient specific instrumentation with laser guidance in a dynamic total hip arthroplasty a radiological evaluation |
| topic | PSI THA patient-specific dynamic planning spinopelvic kinematic pelvic tilt functional orientation of components |
| url | https://www.mdpi.com/1424-8220/21/12/4232 |
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