Development of a novel customized cutting and rotating template for Bernese periacetabular osteotomy
Abstract Background Bernese periacetabular osteotomy (PAO) has been shown to be applicable as a hip-preserving technique for the treatment of developmental dysplasia of the hip (DDH). The approach could be designed preoperatively using various types of reverse-engineering software and finite element...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-019-1267-x |
| _version_ | 1798004982773972992 |
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| author | Xuyi Wang Shixian Liu Jianping Peng Zhonglian Zhu Linlin Zhang Jianzhong Guan Xiaodong Chen |
| author_facet | Xuyi Wang Shixian Liu Jianping Peng Zhonglian Zhu Linlin Zhang Jianzhong Guan Xiaodong Chen |
| author_sort | Xuyi Wang |
| collection | DOAJ |
| description | Abstract Background Bernese periacetabular osteotomy (PAO) has been shown to be applicable as a hip-preserving technique for the treatment of developmental dysplasia of the hip (DDH). The approach could be designed preoperatively using various types of reverse-engineering software and finite element analysis, but how to implement it in the actual PAO remains a challenge. This study examines and evaluates a solution to achieve higher accuracy when performing a PAO. Methods A patient-specific cutting and rotating template was predesigned through computer-aided design (CAD) with three-dimensional (3D) modeling programs. The templates were then reproduced with rapid prototyping (RP) technology and used in the actual PAO. Finally, the clinical and radiographic effects were assessed and compared between the newly developed PAO and conventional PAO groups. Results The customized cutting template fit well with the bone surface and served as a guide for surgeons as they slid the osteotome to the precise location that had been determined prior to surgery. A very similar acetabular fragment was reproduced, and no major complications occurred when performing the osteotomy along the edge of the cutting template. The acetabular fragment was then corrected to the predetermined position through one-off manipulation with the customized rotating template. The final position of the acetabular fragment in the new developed PAO group was highly consistent with the planned position, and the postoperative morphological parameters were consistent with the preoperative planned data compared to the conventional PAO group. The duration of the operation and the number of irradiation decreased significantly. The Harris hip score (HHS) and visual analogue scale (VAS) score improved significantly with the use of the new developed PAO. Conclusions We demonstrate that our system, which was based on CAD-RP technology, is feasible and could realize the predicted results accurately during the actual PAO. |
| first_indexed | 2024-04-11T12:33:02Z |
| format | Article |
| id | doaj.art-260c7c7b04624746bb18a0ac9e4d244c |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T12:33:02Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-260c7c7b04624746bb18a0ac9e4d244c2022-12-22T04:23:42ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-07-0114111010.1186/s13018-019-1267-xDevelopment of a novel customized cutting and rotating template for Bernese periacetabular osteotomyXuyi Wang0Shixian Liu1Jianping Peng2Zhonglian Zhu3Linlin Zhang4Jianzhong Guan5Xiaodong Chen6Department of Orthopaedics, The First Affiliated Hospital of Bengbu Medical CollegeThe First Affiliated Hospital of Bengbu Medical CollegeDepartment of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiaotong University School of MedicineDepartment of Orthopaedics, The First Affiliated Hospital of Bengbu Medical CollegeDepartment of Biomedical Engineering, Shanghai University Of TechnologyDepartment of Orthopaedics, The First Affiliated Hospital of Bengbu Medical CollegeDepartment of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiaotong University School of MedicineAbstract Background Bernese periacetabular osteotomy (PAO) has been shown to be applicable as a hip-preserving technique for the treatment of developmental dysplasia of the hip (DDH). The approach could be designed preoperatively using various types of reverse-engineering software and finite element analysis, but how to implement it in the actual PAO remains a challenge. This study examines and evaluates a solution to achieve higher accuracy when performing a PAO. Methods A patient-specific cutting and rotating template was predesigned through computer-aided design (CAD) with three-dimensional (3D) modeling programs. The templates were then reproduced with rapid prototyping (RP) technology and used in the actual PAO. Finally, the clinical and radiographic effects were assessed and compared between the newly developed PAO and conventional PAO groups. Results The customized cutting template fit well with the bone surface and served as a guide for surgeons as they slid the osteotome to the precise location that had been determined prior to surgery. A very similar acetabular fragment was reproduced, and no major complications occurred when performing the osteotomy along the edge of the cutting template. The acetabular fragment was then corrected to the predetermined position through one-off manipulation with the customized rotating template. The final position of the acetabular fragment in the new developed PAO group was highly consistent with the planned position, and the postoperative morphological parameters were consistent with the preoperative planned data compared to the conventional PAO group. The duration of the operation and the number of irradiation decreased significantly. The Harris hip score (HHS) and visual analogue scale (VAS) score improved significantly with the use of the new developed PAO. Conclusions We demonstrate that our system, which was based on CAD-RP technology, is feasible and could realize the predicted results accurately during the actual PAO.http://link.springer.com/article/10.1186/s13018-019-1267-xPeriacetabular osteotomyDevelopmental dysplasia of the hip3D printing technologyCustomized template |
| spellingShingle | Xuyi Wang Shixian Liu Jianping Peng Zhonglian Zhu Linlin Zhang Jianzhong Guan Xiaodong Chen Development of a novel customized cutting and rotating template for Bernese periacetabular osteotomy Journal of Orthopaedic Surgery and Research Periacetabular osteotomy Developmental dysplasia of the hip 3D printing technology Customized template |
| title | Development of a novel customized cutting and rotating template for Bernese periacetabular osteotomy |
| title_full | Development of a novel customized cutting and rotating template for Bernese periacetabular osteotomy |
| title_fullStr | Development of a novel customized cutting and rotating template for Bernese periacetabular osteotomy |
| title_full_unstemmed | Development of a novel customized cutting and rotating template for Bernese periacetabular osteotomy |
| title_short | Development of a novel customized cutting and rotating template for Bernese periacetabular osteotomy |
| title_sort | development of a novel customized cutting and rotating template for bernese periacetabular osteotomy |
| topic | Periacetabular osteotomy Developmental dysplasia of the hip 3D printing technology Customized template |
| url | http://link.springer.com/article/10.1186/s13018-019-1267-x |
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