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  • Use of 3D modelling and 3D printing for the diagnostic process, decision making and preoperative planning of periprosthetic acetabular fractures

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Novel diagnostic procedure
Case report
Use of 3D modelling and 3D printing for the diagnostic process, decision making and preoperative planning of periprosthetic acetabular fractures
  1. Giuseppe Marongiu1,
  2. Roberto Prost2 and
  3. Antonio Capone1
  1. 1 Orthopedic and Trauma Clinic, University of Cagliari, Cagliari, Sardegna, Italy
  2. 2 Radiology, Azienda Ospedaliera Brotzu, Cagliari, Sardegna, Italy
  1. Correspondence to Dr Giuseppe Marongiu; giuse.marongiu{at}gmail.com

Abstract

Periprosthetic acetabular fractures represent an uncommon but challenging complication of total hip arthroplasty (THA), mostly related to low-energy trauma and pathological conditions that reduce bone quality. Therefore, particularly in elderly patients, these fractures are associated with periprosthetic osteolysis and bone loss. CT scan is considered the gold standard to define the fracture pattern; however, the presence of the prosthetic implants in situ limits the full view of the articular surface and bone loss. A three-dimensional (3D) modelling software allows precise tridimensional reconstructions of the bony surface, virtually removing the metallic implants trough DICOM image segmentation. We highlight the case of a periprosthetic acetabular fracture around THA which occurred to a 75-year-old woman, in which a 3D modelling software was used to improve the assessment of fracture morphology and bone quality. Moreover, the 3D images were printed in a real-life size model and were used for preoperative implant templating, sizing and surgical simulation.

  • prosthesis failure
  • orthopaedic and trauma surgery
  • orthopaedics

http://dx.doi.org/10.1136/bcr-2019-233117

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    Footnotes

    • Contributors GM, RP and AC equally contributed to the conception and design of the work and the acquisition, analysis and interpretation of data; contributed equally to manuscript’s drafting for important intellectual content; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. RP performed CT scan analysis and tridimensional digital reconstruction and contributed to the acquisition, analysis and interpretation of data.All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.