28 November, 2019
Preoperative planning for hip and knee prostheses with 3D printing
Hip prosthesis or knee prosthesis replacement is a complex surgery, which becomes even more complicated when there are major bone defects. Surgical strategies and prosthetic models can vary greatly depending on the existing bone deformities. Therefore, preoperative planning is essential for the successful outcome of the surgery. Thanks to 3D printing technology, surgeons can plan the surgery in advance with great detail. Let’s see what 3D printing for preoperative planning consists of, as well as its advantages.
WHAT IS PREOPERATIVE PLANNING?
Preoperative planning is a routine stage in the surgeon’s preparation for a total hip or knee replacement surgery. During this pre-op stage, the surgeon identifies biomechanical, anatomical and surgical technique factors, which are key factors during the surgery. He can then choose which implants are to be used, thus reducing surgical time and increasing the functionality and longevity of arthroplasty. The success of prosthetic surgeries relies greatly on the type of components used and their proper positioning. Furthermore, during preoperative planning the size of the components is carefully selected, so as to reduce the risk of fractures and to help restore the functionality of the knee or hip.
“During preoperative planning the size of the components is carefully selected, so as to reduce the risk of fractures and to help restore the functionality of the knee or hip”
3D PRINTING FOR SURGICAL PLANNING
With the development of high-precision digital medical images, 3D printing technology has provided real anatomy models to successfully perform complex surgeries. The surgeon can use 3D models to simulate the operation, in order to improve its success rate.
Hip and knee surgeons usually rely on conventional radiography or digital radiography to plan their surgeries. Two dimensions (2D) is the traditional surgical planning method in Orthopedic Surgery and Traumatology. One of the main problems with traditional or digital radiography planning is that it only works in two dimensions whereas bone anatomy has three dimensions (3D), so image precision could be lost.
3D printing surgical planning uses variables that can’t be conceived in 2D, which are especially useful with hip or knee prosthesis revision surgeries. These types of interventions deal with severe bone defects where bone anatomy is very damaged. Thanks to 3D printing technology, surgeons can plan the surgery in advance with great detail. It allows the surgeon to see in advance the bone or joint on which he or she will work with, thus familiarising with the volumetry of the piece. Surgeons can therefore run real simulations of the technique to be applied, which leads to a more accurate and safer surgery.
“3D printing offers the possibility to run real simulations of the technique to be applied, which leads to a more accurate and safer surgery”
ADVANTAGES OF 3D TECHNOLOGY FOR SURGICAL PLANNING
The advantages of 3D printing for surgical planning are the possibility to plan and optimise the material resources used in the intervention and shorter operation time, avoiding improvisation. This also means shorter anesthesia, which reduces infection and bleeding probabilities. Ultimately, it also favours patients’ recovery.
DR. GUILLEM BORI, REFERENCE IN 3D PRINTING FOR SURGICAL PLANNING
Dr. Guillem Bori has extensive experience in preoperative planning of prostheses surgeries, specialising especially in 3D printing for surgical planning. He was in fact the lead researcher of a 2015 3D planning project awarded with the Dr. Josep Trueta Scholarship in research assistance, granted by the Catalan Society of Orthopedic Surgery and Traumatology.