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. 2021 Oct 13;57(5):884-890.
doi: 10.1055/s-0041-1731659. eCollection 2022 Oct.

Comparative Study with and without the Use of 3D Prototyping of an Unconventional Technique in the Surgical Planning of Revision of Total Hip Arthroplasty

Alonso Ranzzi  1   2 , Rafael de Luca de Lucena  3   4 , Carlos Roberto Schwartsmann  3   5 , Carlos Roberto Galia  6 , Marina Cornelli Girotto  3   4 , Leandro de Freitas Spinelli  5   7
Affiliations

Comparative Study with and without the Use of 3D Prototyping of an Unconventional Technique in the Surgical Planning of Revision of Total Hip Arthroplasty

Alonso Ranzzi et al. Rev Bras Ortop (Sao Paulo). .

Abstract

This article presents a comparison between two cases in which there was a need for revision of total hip arthroplasty due to aseptic acetabular failure. We used 3D prototyping in one of the cases to perform an unconventional technique of molding synthesis material before the procedure to evaluate the time saved in the transoperative period in complex cases.

Keywords: 3D printing; arthroplasty, replacement, hip; surgical planning.

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Conflict of interest statement

Conflito de Interesses Os autores declaram não haver conflito de interesses.

Figures

Fig. 1
Fig. 1
( A ) Preoperative radiographs (case 1). ( B ) Postoperative radiographs.
Fig. 2
Fig. 2
3D prototype (case 1) printed after being processed based on a computed tomography scan.
Fig. 3
Fig. 3
( A ) Ipsilateral iliac and posterolateral incisions (case 1). ( B ) Transoperative image of cemented acetabular component to be revised. ( C-D ) Acetabular component removed. ( E ) Acetabular failure after removal of the acetabular component. ( F ) Molded reconstruction plate embedded in the acetabulum. ( G ) Planning using the 3D biomodel with the precast plate.
Fig. 4
Fig. 4
( A ) Reconstruction plate and acetabular cutter for preoperative planning. ( B ) Autologous bone graft of the iliac structured as a lid. ( C ) Graft cover used in the acetabular fundus to avoid cement extravasation into the pelvis. ( D ) Final result of the cemented acetabular component reviewed.
Fig. 5
Fig. 5
( A ) Preoperative radiograph evidencing important osteoarthrosis in the right hip (case 2). ( B ) Immediate postoperative radiograph. ( C ) Postoperative radiograph 15 years later, with Paprosky type-3B failure. ( D ) Immediate postoperative radiograph of the revision sugery. ( E ) Postoperative radiograph with two years of evolution, evidencing osteointegration of the graft in the acetabular fundus.
Fig. 1
Fig. 1
( A ) Radiografias pré-operatórias (caso 1). ( B ) Radiografias pós-operatórias.
Fig. 2
Fig. 2
Prototipagem impressa em 3D (caso 1) após ser processada a partir de tomografia computadorizada.
Fig. 3
Fig. 3
( A ) Incisões operatórias posterolateral e ilíaco ipsilateral (caso 1). ( B ) Imagem transoperatória do componente acetabular cimentado a ser revisado. ( C-D ) Componente acetabular retirado. ( E ) Falha acetabular após a retirada do componente acetabular. ( F ) Placa de reconstrução moldada encaixada no acetábulo. ( G ) Planejamento utilizando o biomodelo em 3D com a placa pré-moldada.
Fig. 4
Fig. 4
( A ) Placa de reconstrução e fresa acetabular para planejamento pré-operatório. ( B ) Enxerto ósseo autólogo do ilíaco estruturado em tampa. ( C ) Tampa de enxerto utilizada no fundo acetabular para evitar o extravasamento de cimento para dentro da pelve. ( D ) Resultado final do componente acetabular cimentado revisado.
Fig. 5
Fig. 5
( A ) Radiografia pré-operatória evidenciando importante osteoartrose em quadril direito (caso 2). ( B ) Radiografia de pós-operatório imediato. ( C ) Radiografia pós-operatória 15 anos após, com falha acetabular de tipo 3B de Paprosky. ( D ) Radiografia pós-operatória imediata da revisão. ( E ) Radiografia pós-operatória com 2 anos de evolução, evidenciando osteointegracão do enxerto no fundo acetabular.
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