Both surgical planning and medical 3D Printing are providing surgeons with more options for the surgical treatment of hip patients. With complex hip revision surgery in mind, we recently organized a webinar to present the range of planning and patient-specific surgical solutions offered by Materialise. These include X-ray based planning, 3D-printed anatomical models, and patient-specific surgical guides and implants. We also refer to this as the Materialise Hip Continuum.
For this webinar, we gathered the product managers for these innovative products to talk about the key stages of the Materialise Hip Continuum and how these technologies can offer specific benefits to you, and your patients, in complex cases.
X-ray based planning
Materialise OrthoView Product Manager Eddy Isanski was the first to present a thorough overview of X-ray based planning. Replacing analogue templating and planning using printed X-rays, Materialise OrthoView provides orthopaedic hip specialists with a means to plan primary and revision joint replacement procedures with conventional hip implants digitally, identifying the preferred size and position of the implant.
Referring to the case of a 65 year old who’d had a primary hip replacement in 1995 and experienced aseptic loosening after 19 years, Eddy demonstrated how the software was used to plan the hip revision surgery.
Of course, a good X-ray and a well-positioned marker are recommended to get the most from X-ray-based planning. With a good X-ray, Eddy was able to identify poor cement mantle and bone condition, and the need to remove the cement plug. This approach enables surgeons to quickly and accurately quantify their observations using a range of planning wizards and tools.
Moving on to templating, Eddy positioned the acetabular cup and stem and selected the appropriate implant whilst considering variables of the shaft, body and head length.
The software also allows surgeons to experiment with different options and helps to anticipate problems, ensuring better preparation for surgery.
Patient-specific guides and 3D planning
Dieter Vandoren, product manager for hip guides at Materialise, took the floor next, to outline the benefits of patient-specific guides and 3D planning for total hip arthroplasty.
Dislocation is the number one short term complication following hip replacement surgery*. Correct acetabular cup orientation reduces dislocation rates** and prevents wear and early failure*** which is the most common long-term complication leading to revision surgery in hip cases. During the webinar, Dieter demonstrated how a patient-specific guide and anatomical model of the acetabulum help surgeons achieve accurate cup orientation.
3D-printed hip implants
Dieter then introduced Materialise product manager Nadia Van Geel to provide an overview of the Materialise aMace hip revision system which comprises of completely personalized implants. As every patient is unique, a patient-specific approach can be used, from CT scanning to surgery to deliver the best solution for each case.
Using an anatomical model, the amount of bone missing in the femoral region can be quantified to establish how much bone remains and the quality of it. In surgery, an amount of bone may need to be removed. This is shown and quantified on the implant design.
Furthermore, a personalized fixation plan is created. Screws are positioned in the areas with the best bone quality and in different directions for optimal resistance to loosening. Drill guides are also available to transfer computerized screw planning into surgery.
The Materialise Hip Continuum is finalized when a custom implant is provided, along with patient-specific tools, drill guides and a trial implant that is made available for testing during surgery. Materialise offers orthopaedic hip surgeons more options for achieving the best possible outcome for their patients through planning and patient-specific solutions.
Note: The Materialise aMace acetabular revisions system and patient-specific guides are not commercially available in the United States and Canada.
*Philips et al, (2010), JBJS ** Moskal et al, (2010), JAOS ***Cooper et al, (1992), JARTH