3D Applications in Hip Surgery


Alessandro Aprato, MD
San Luigi Hospital of Orbassano, University of Turin, Torino, Italy

Series: Surgery – Procedures, Complications, and Results, Orthopedic Research and Therapy
BISAC: MED085000

Recent studies demonstrated the utility of advanced imaging techniques including 3D CT collision modeling, MRI 3D reconstruction and 3D fluoroscopy in hip surgery. Collision modeling including software based on a CT scan and 3D fluoroscopy are able to predict the specific zone of femoral-acetabular impingement and are useful tools to plan the bone resection in preserving hip surgery. Furthermore, they may be helpful for the evaluation of acetabular coverage in hip dysplasia and may predict the amount of correction needed during a periacetabular reorientation osteotomy.

On the other hand, CT based prototyping and the custom 3D-printed implants have emerged as new options to address severe bone loss or compromised anatomy. Although, there is little published literature so far, the interest for this technology in hip arthroplasty is growing. Patient and defect-specific implants are designed from CT images and then may be printed via a 3D model or may generate into a one-piece product. Those solutions may be helpful in primary arthroplasty: first, they may be used in a complex case where a standard implant may not be easy to be performed because of the alteration of the bone structure; eventually, they may be used in oncologic cases where a great amount of bone should be resected. Custom implants find indications also in revision arthroplasty, where the bone loss is important. In fact, the resulting precision-fit of the implant to the remaining patient’s bonestock minimizes the need for more bone resection to fit an off-the-shelf product. Locking screw configurations may be planned preoperatively to obtain the most efficient purchase in the existing bone. Furthermore, by combining angiography from the planning CT, locking screw trajectory can be planned so as to maximize a fixation whilst minimizing vascular risk. (Imprint: Nova Biomedical)

Table of Contents

Table of Contents


Chapter 1. CT Scan and 3D Applications for Hip Surgery
T. Robba, D. Molino, D. Martorano and A. Borre’ (Radiology Department, City of Health and Science in Turin, C.T.O. Hospital, Italy)

Chapter 2. 3D Fluoroscopy and Its Applications in Hip Surgery
M. Giachino, A. Aprato, C. Degiorgis, L. Conforti, G. Massazza and A. Massè (University of Turin, Turin, Italy, and others)

Chapter 3. MRI and 3D Applications for Hip Surgery
M Busso, M Falco, E. Shaipi, G Gallo, P Arnoffi and A Veltri (University of Turin, Turin, Italy, and others)

Chapter 4. A Virtual Model in Hip Preserving Surgery
P. Di Benedetto, M. Buttironi and A. Causero (Orthopedic Clinic, Udine Integrated Healthcare Company, Italy)

Chapter 5. The Limits and Future of Collision Models
A. Aprato, F. Palmesino, L. Ulrich, E. Vezzetti, M. Giachino and A. Massè (University of Turin, Turin, Italy, and others)

Chapter 6. 3D Customizing in Complex Primary Hip Replacement
A. Aprato, S. De Vivo, F. Marra, A. Nicodemo, A. Bistolfi and A. Massè (University of Turin, Turin, Italy, and others)

Chapter 7. 3D Customizing in Revision Hip Replacement
A. Aprato, A. D’Amelio, F. Marra, M. Favuto, D. Mellano and A. Massè (University of Turin, Turin, Italy, and others)

Chapter 8. 3D Customizing in Oncologic Hip and Pelvic Surgery
M Boffano, P Pellegrino, N Ratto and R Piana (Oncologic Orthopaedic Division, Department of Orthopaedics and Traumatology, Orthopaedic and Trauma Center, Turin, Italy)


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