The study of the total hip arthroplasty using 3D printing technology

Abstract

Background: The population of the Inner Mongolia Autonomous Region has high rates of TB and developmental dysplasia of the hip (DDH), and patients are more likely to be admitted to the hospital at a later stage and to have Crowe type III or IV developmental dysplasia of the hip.2,6 The primary treatment for developmental dysplasia and TB of the hip is total hip arthroplasty,7,41 and a comparative study of total hip arthroplasty using conventional methods and three-dimensional printing technology is a crucial topic that needs to be addressed. Objective: To compare total hip arthroplasty result using three-dimensional printing technology with conventional hip arthroplasty in patients with severe hip deformity. Materials and methods: The study selected patients with hip TB and Crowe type III or IV developmental dysplasia of the hip and duration of conventional hip arthroplasty and hip replacement surgery using 3D printing technology, intraoperative bleeding, complications, postoperative recovery, Harris score assessment within 12 months after surgery, and the difference between the measurement of the angle of the lateral joint and hip in two groups. Results: We compared the results of total hip arthroplasty using 3D printing technology to 51 patients with developmental dysplasia of the hip and hip joint tuberculosis and 56 patients with conventional hip arthroplasty from June 2018 to June 2019. A total of 24 (47.1%) patients with developmental dysplasia of the hip out of 51 patients who underwent surgery using the 3D printing technology were found to have Crowe II stage 5, Crowe III stage 8, and Crowe IV stage 11 patients, which was consistent with the stage determined using the 3D model. However, 27 (52.9%) patients with hip tuberculosis were found to have 9 patients with bone tuberculosis and 18 patients with hip joint tuberculosis. The preoperative plan using the 3D model is fully consistent with the plan for total hip arthroplasty, which has the clinical significance of dramatically improving surgical outcomes and improving the safe and optimal quality of clinical diagnosis and treatment. The surgical duration of the 3D hip arthroplasty group (39.9±10.3), intraoperative bleeding, and postoperative recovery time were shorter than those of the conventional hip arthroplasty group (63.7±10.3). When choosing the location and size of the hip implants for 51 patients who underwent 3D hip arthroplasty, the 3D-modeled surgery was fully consistent with the 3D hip arthroplasty result. The location and intended size of the 51 hip prosthetic implants: The acetabular cup, femoral ball and stem were the same and appropriate. In addition, the difference in Harris score estimates between the two groups of patients were statistically insignificant (p> 0.05). The postoperative Harris score of the 3D hip arthroplasty group was higher than the conventional hip arthroplasty group and statistically significant (p<0.01). Conclusions: 1. The stage of severe hip deformity identified using a 3D printed model and the preoperative plan tailored to each patient is fully validated during actual hip replacement surgery, reducing the surgery’s duration and complexity. 2. The femoral neck anteversion of the hip arthroplasty patient using 3D printing technology was significantly less than that of the conventional hip arthroplasty group and statistically significant (P <0.05). 3. The Harris score (93.3±2.7) after hip arthroplasty surgery using 3D printing technology was statistically significant (p<0.01), higher than the conventional hip arthroplasty group (81.2±2.8) and the time to recover and start exercising was short.