Accuracy and reproducibility of three-dimensional planning based on CT data for predicting prosthesis type and osteotomy in total hip arthroplasty

doi:10.12307/2021.185

Abstract

Abstract: BACKGROUND: The correct choice of prosthesis size and accurate biomechanical reconstruction are important factors affecting the postoperative function of total hip arthroplasty. Accurate preoperative planning can provide information for accurate reconstruction in advance. Osteotomy distance and tip shoulder distance are important reference indexes for femoral stem implantation depth and intraoperative control of the length of both lower limbs. Preoperative planning measurement is very important.
OBJECTIVE: To assess the accuracy and reproducibility of three-dimensional (3D) preoperative planning simulation of primary total hip arthroplasty based on hip CT data.
METHODS: We retrospectively analyzed medical records of 50 patients (52 hips) who underwent primary total hip arthroplasty with cementless prosthesis. The data of each patient’s preoperative double hip CT thin-layer scanning were collected and imported into Mimics 19.0 software in DICOM format for 3D modeling of the hip joint. The 3D scanner was used to scan each size of prosthesis sample. The 3D PINNACLE cup, SUMMIT and CORAIL prosthesis models were established by Geomagic Studio 2012 software. The prosthesis models were imported into Mimics software to simulate prosthesis implantation on the established hip joint model. After placing the prosthesis, the prosthesis model was recorded, and the femoral neck osteotomy distance and tip shoulder distance were measured. Similarly, the osteotomy height and tip shoulder distance were measured postoperatively, and the results of 3D preoperative planning were compared with the actual results after operation. Pearson Correlation Coefficient was used to determine the correlation between variables before and after planning.
RESULTS AND CONCLUSION: (1) The accuracy of 3D preoperative planning based on CT data in planning the cup, the stem, combining both the cup and the stem was 92%, 96% and 94%, respectively. (2) The osteotomy distance and the tip shoulder distance before and after the operation had strong repeatability (osteotomy distance: r=0.825, P < 0.05, tip shoulder distance: r=0.862, P < 0.05). Partial correlation coefficient analysis showed that the correlation between preoperative and postoperative osteotomy distance and tip shoulder distance was still strong (osteotomy distance: r’=0.783, P < 0.05; tip shoulder distance: r’=0.843, P < 0.05). The absolute error of osteotomy distance was (0.07±1.64) mm, and the absolute error of tip shoulder distance was (-0.24±1.58) mm. (3) It is concluded that 3D preoperative planning based on CT data not only has high accuracy in predicting the size of prosthesis, but also can accurately reconstruct the osteotomy distance and tip shoulder distance. 3D preoperative planning has good reproducibility in primary total hip arthroplasty, which can provide good reference value for surgeons in clinical practice, so as to avoid intraoperative and postoperative complications.

Key words: 3D preoperative planning, total hip arthroplasty, osteotomy distance, tip shoulder distance

CLC Number:

Huo Jiabang, Zhao Chang, Huang Guangxin, Wang Xinjie, Bu Yufan, Zhu Jinjian, Cai Daozhang . Accuracy and reproducibility of three-dimensional planning based on CT data for predicting prosthesis type and osteotomy in total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(27): 4294-4299.

Figures/Tables 5

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