Born with Down syndrome and undergoing treatment for leukemia, Jalanea was diagnosed at 5 years old with Atlanto-axial instability – a dangerous point of weakness between spine and skull. Clinicians at Ochsner Hospital for Children used 3D anatomical modeling, generated by Materialise’s Mimics inPrint software, to help plan and successfully execute a complicated procedure that would ultimately save a brave little girl’s life.
Digital pre-operative planning allows the surgeon to easily assess the size of components required, as well as other factors that the duration of the procedure. Having considered a variety of options in advance of the procedure, the surgeon was able to ensure both the equipment and his staff were prepared, thus saving valuable time in the OR.
A 64-year-old patient suffered from severe complications related to total shoulder arthroplasty performed several years ago. His diagnosis claimed a defect with abnormal ossification surrounding the glenoid. Due to the complexity and unusual size of this particular defect, implementing a patient-specific 3D-Printed Glenius implant seemed to offer the best solution. Prof. Dr. Stefaan Nijs (Belgium) proceeded with a two-stage revision procedure based on detailed 3D preoperative planning.
The patient, an 86 year-old woman who was the primary caregiver for her husband, had previously been an active person in the local community. She was experiencing increasing right knee pain and deformity and was unable to walk without the use of a cane. A physical examination revealed antero-posterior and medial instability with 10-degree hyperextension to 90-degree flexion
The patient has a history of hypophosphatemic rickets. The associated bone abnormalities and leg malalignment had been addressed by bilateral closing wedge tibial osteotomies when the patient was approximately 40 years of age. The patient was now experiencing pain in both knees and was having difficulty walking.
A 60 year old lady was suffering from shoulder pain and limited range of motion. Analysis of the medical images indicated a devastating shoulder arthrosis with severe medialization and erosion of the glenoid. Due to a complete loss of the glenoid vault, implantation of a classic pegged baseplate for reverse total shoulder was not an option. In addition, interposition of a massive bone graft would have little chance for ingrowth and survival, hence little chance to offer sufficient stability.
At the age of 81, the patient was suffering from a Paprosky type 3B defect and already underwent hip revision surgeries prior to seeking the help of Mr. Dunlop. He is not alone, because data from joint registries show that 27% of the revisions is not an initial one and those re-revisions have a 3 times higher chance of failure compared to initial revisions.
Total hip replacement is widely considered a very successful surgery to relieve pain and restore mobility to patients. Since the shape of every patient's femur is different, the femoral offset, anteversion angle and length can vary widely between patients. Therefore, to achieve good functional results, an accurate restoration of hip biomechanics with appropriate implant and sizing options is essential.
Solutions: FEA, Magics, Magics 3D Print Suite, Metal 3D Printing
In this case study, we investigate different part-support configurations of a patient-specific CMF implant, and determine which configuration is most suitable for the AM process. We do this by simulating deformations via inherent strain method and comparing the final deformations of the parts after support removal.
A 43 year-old female runner suffered a displaced right femoral neck stress fracture that failed to heal with conservative treatment. She was treated at an outside hospital with percutaneous reduction and internal fixation.
Dr. Mehta is an enthusiastic advocate of digital pre-operative planning and has selected OrthoView software as the solution for his division. Here he explains how his division will benefit from using OrthoView for planning and templating procedures.
This total hip arthroplasty (THA) revision case presented by Mr. Grant Shaw is part of our “Plan to Know” with Orthopaedic Digital Templating Case Study Series, in which orthopaedic surgeons describe cases in which digital pre-operative did or would have enabled better preparation for the OR.