Use of 3D Printing in Planning the Reconstruction of Total Hip Arthroplasty: A Teaching Tool

The present study aims to demonstrate how biomodels can be used as teaching tools for surgical techniques and training in a medical residency service.

A case series was carried out in our orthopedics and traumatology outpatient facility using three-dimensional (3D) printing for surgical planning to contribute to the surgical teaching and training of resident physicians. Two cases were selected as examples in the present article.

Biomodels enable a better understanding of the surgery by the surgical team and residents, reducing the surgical time and the risks for the patients.

These models can be a good teaching method to plan reconstructions of total hip arthroplasties, evaluate and predict surgical difficulties, and optimize procedures.

Keywords
arthroplasty; replacement; hip; hip/surgery; printing; threedimensional; models; anatomic

Authorship

Marina Cornelli Girotto

Orthopedics and Traumatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, BrazilUniversidade Federal de Ciências da Saúde de Porto AlegreBrazilPorto Alegre, RS, BrazilOrthopedics and Traumatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil

Orthopedics and Traumatology Service, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, BrazilSanta Casa de Misericórdia de Porto AlegreBrazilPorto Alegre, RS, BrazilOrthopedics and Traumatology Service, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil

http://orcid.org/0000-0002-3390-903X

Rafael de Luca de Lucena

http://orcid.org/0000-0002-0952-7488

Carlos Roberto Schwartsmann

Department of Clinical Surgery, Faculdade de Medicina, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, BrazilUniversidade Federal de Ciências da Saúde de Porto AlegreBrazilPorto Alegre, RS, BrazilDepartment of Clinical Surgery, Faculdade de Medicina, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil

http://orcid.org/0000-0002-8669-3084

Ary da Silva Ungaretti Neto

http://orcid.org/0000-0002-6729-8687

Gisele Orlandi Introini

Department of Basic Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, BrazilUniversidade Federal de Ciências da Saúde de Porto AlegreBrazilPorto Alegre, RS, BrazilDepartment of Basic Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil

http://orcid.org/0000-0003-1946-2662

Leandro de Freitas Spinelli

Graduate Program in Manufacturing Projects and Processes, Bioengineering, Biomechanics and Biomaterials Laboratory, Universidade de Passo Fundo, Passo Fundo, RS, BrazilUniversidade de Passo FundoBrazilPasso Fundo, RS, BrazilGraduate Program in Manufacturing Projects and Processes, Bioengineering, Biomechanics and Biomaterials Laboratory, Universidade de Passo Fundo, Passo Fundo, RS, Brazil

http://orcid.org/0000-0001-8125-7104

*
Study developed at the Orthopedics and Traumatology Service of Santa Casa de Misericórdia de Porto Alegre and at Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, with the collaboration of the Bioengineering, Biomechanics and Biomaterials Laboratory of Universidade de Passo Fundo, Rio Grande do Sul, Brazil.

Address for correspondence Marina Cornelli Girotto, MD, Serviço de Ortopedia e Traumatologia - Santa Casa de Misericórdia de Porto Alegre, Rua Professor Annes Dias, 135, 2o andar, Centro Histórico, Porto Alegre, Rio Grande do Sul, 90460-150, Brazil (e-mail: marinacgirotto@gmail.com).

Conflict of Interests

The authors have no conflict of interests to declare.

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (2)

Thumbnail

Fig. 1
Preoperative radiographs of the pelvis (A) and lateral view of the right hip (B) at the time of the review, revealing animportant acetabular bone failure with loosening of the components. (C) View of the printed prototyping model; (D) residents training with prototyping models; (E) cavity and (F) acetabulum preparation with visualization of the bone defect and its filling with chopped, impacted bone; (G) planning of the size and position of the implant; (H) postoperative radiograph of the revision of the right total hip arthroplasty.

Thumbnail

Fig. 2
(A, B) Preoperative radiographs of the pelvis and lateral view of the left hip; (C, D) computed tomography scans; (E) visualization of the extensive acetabular lesion; (F) study of the situation; (G) assembly of a new arrangement with trabeculated metal and study of its anchoring; (H) placement of the new acetabulum; (I) positioning the cemented polyethylene; (J) visualization of the intraoperative lesion (note the virtual absence of the acetabular roof and of the anterior and posterior walls); (K) assembly of the trabeculated metal structure; (L) placement of divergent screws and chopped, impacted bone graft; (M) placement of the trabeculated metal cup after deposition of a thin layer of cement between the metal components to avoid metallic contact; (N) acetabulum cementation at the proper position; (O) immediate postoperative radiograph; and (P) radiograph three years after the procedure (note the graft integration).

Fig. 1 Preoperative radiographs of the pelvis (A) and lateral view of the right hip (B) at the time of the review, revealing animportant acetabular bone failure with loosening of the components. (C) View of the printed prototyping model; (D) residents training with prototyping models; (E) cavity and (F) acetabulum preparation with visualization of the bone defect and its filling with chopped, impacted bone; (G) planning of the size and position of the implant; (H) postoperative radiograph of the revision of the right total hip arthroplasty.

Fig. 2 (A, B) Preoperative radiographs of the pelvis and lateral view of the left hip; (C, D) computed tomography scans; (E) visualization of the extensive acetabular lesion; (F) study of the situation; (G) assembly of a new arrangement with trabeculated metal and study of its anchoring; (H) placement of the new acetabulum; (I) positioning the cemented polyethylene; (J) visualization of the intraoperative lesion (note the virtual absence of the acetabular roof and of the anterior and posterior walls); (K) assembly of the trabeculated metal structure; (L) placement of divergent screws and chopped, impacted bone graft; (M) placement of the trabeculated metal cup after deposition of a thin layer of cement between the metal components to avoid metallic contact; (N) acetabulum cementation at the proper position; (O) immediate postoperative radiograph; and (P) radiograph three years after the procedure (note the graft integration).

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Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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Use of 3D Printing in Planning the Reconstruction of Total Hip Arthroplasty: A Teaching Tool

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[1] *
Study developed at the Orthopedics and Traumatology Service of Santa Casa de Misericórdia de Porto Alegre and at Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, with the collaboration of the Bioengineering, Biomechanics and Biomaterials Laboratory of Universidade de Passo Fundo, Rio Grande do Sul, Brazil.