PREOPERATIVE 3D MODELING AND PRINTING FOR GUIDING PERIACETABULAR OSTEOTOMY. Issue 7 (30th July 2021)

• Record Type: Journal Article
• Authors: Shelton, Trevor J.; Shafagh, Monazzam; Calafi, Arash; Leshikar, Holly B.; Haus, Brian M.
• Is Part Of: Orthopaedic journal of sports medicine. Volume 9:Issue 7(2021)Supplement 3
• Publication Date: 2021-07-30
• Subjects: Sports medicine -- Periodicals; Orthopedics -- Periodicals; Arthroscopy -- Periodicals; Arthroplasty -- Periodicals; Knee -- Surgery -- Periodicals; 616.7
• DOI: 10.1177/2325967121S00026
• Languages: English
• ISSNs: 2325-9671

Abstract

Background: Achieving adequate acetabular correction in multiple planes is essential to the success of Periacetabular Osteotomy (PAO). Three-dimensional (3D) modeling and printing has the potential to improve preoperative planning by accurately guiding intraoperative correction. Hypothesis/Purpose: We, therefore, asked the following questions: 1) For a patient undergoing a PAO, does 3D-modeling with intraoperative 3D-printed models create a reproducible surgical plan to obtain predetermined parameters of correction including lateral center-edge angle (LCEA), anterior center-edge angle (ACEA), Tonnis angle, and femoral head extrusion index (FHEI), 2) Can 3D computer modeling accurately predict when a normalized FHEI can be achieved without the need for a concomitant femoral sided osteotomy? Methods: A retrospective review was conducted on forty-two (42) consecutive patients that underwent a PAO. 3D-modeling software was utilized to simulate a PAO in order to achieve normal LCEA, ACEA, Tonnis angle, and FHEI. If adequate FHEI was not achieved, a femoral osteotomy was simulated. 3D-models were printed as intraoperative guides. Preoperative, simulated, and postoperative ACEA, LCEA, Tonnis angle, and FHEI were measured and compared statistically. Results: 40 patients had a traditional PAO, and 2 had an anteverting-PAO. The simulated LCEA, ACEA, Tonnis angle, and FHEI were within a median difference of 3º, 1º, 1°, and 0% of postoperative values, respectively and showed no statistical difference. Of those that had a traditional PAO, all thirty-four (34) patients were correctly predicted to need a traditional acetabular sided correction alone and the other six (6) were correctly predicted to need a concomitant femoral osteotomy for a correct prediction in 100% of patients. Conclusion: This study demonstrated that in PAO, 3D-modeling and printing allow the surgeon to accurately create a reproducible surgical plan to obtain predetermined postoperative hip coverage parameters. This new technology has the potential to improve preoperative/intra-operative decision making for hip dysplasia and other complex disorders of the hip.