Jennings Jason M, Jones Tristan, Madurawe Chameka S, Pierrepont Jim, Abila Paula, Dennis Douglas A
Colorado Joint Replacement, Denver, CO, USA.
Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA.
Hip Int. 2025 Mar;35(2):124-129. doi: 10.1177/11207000241307378. Epub 2025 Jan 8.
A primary objective when performing a total hip arthroplasty (THA) is to restore hip biomechanics in accordance with a chosen surgical plan. The aim of this study was to assess the accuracy of a 3D-printed patient-specific guide for delivering a planned femoral osteotomy for both a posterior and an anterior approach.
40 patients (20 anterior and 20 posterior) scheduled for THA received a preoperative work-up allowing for patient-specific implant sizing and positioning. Following surgeon confirmation, a patient-specific guide was designed and printed, enabling the desired osteotomy to be executed. Achieved osteotomies were assessed using commercially available software platforms. Planning accuracy was also assessed using both the planning platform as well as more traditional 2D-templating techniques.
The mean deviation between the planned and achieved osteotomy level was -0.6 mm (range -4.1-6.4 mm). 95% of the achieved osteotomy levels were within 3 mm of the plan for both the posterior and anterior approach groups. 70% of the Optimized Positioning System (OPS) planned femoral components were the exact size as planned versus 25% of the 2D-planned components. 98% of the OPS planned femoral components were within 1 size of plan versus 58% for the 2D-planned components. No sizing accuracy difference was observed between planning approaches ( = 0.70).
A patient-specific osteotomy guide can be a simple and accurate method to reproduce a planned femoral neck resection through an anterior or posterior approach. Further, 3D planning appears to more accurately predict femoral sizing in THA than more conventional 2D methods.
进行全髋关节置换术（THA）的一个主要目标是根据选定的手术方案恢复髋关节生物力学。本研究的目的是评估一种3D打印的患者特异性导板用于后路和前路手术中实施计划股骨截骨的准确性。
40例计划行THA的患者（20例前路和20例后路）接受术前检查以确定患者特异性植入物的尺寸和位置。经外科医生确认后，设计并打印患者特异性导板，以实施所需的截骨术。使用商用软件平台评估实际完成的截骨情况。还使用计划平台以及更传统的二维模板技术评估计划准确性。
计划截骨水平与实际完成截骨水平之间的平均偏差为-0.6毫米（范围为-4.1至6.4毫米）。后路和前路手术组中，95%的实际截骨水平在计划的3毫米范围内。优化定位系统（OPS）计划的股骨组件中，70%的尺寸与计划完全一致，而二维计划组件的这一比例为25%。OPS计划的股骨组件中，98%的尺寸在计划的1个尺寸范围内，而二维计划组件的这一比例为58%。两种计划方法之间未观察到尺寸准确性差异（P = 0.70）。
患者特异性截骨导板可以是一种简单且准确的方法，用于通过前路或后路手术重现计划的股骨颈切除术。此外，与更传统的二维方法相比，3D计划在THA中似乎能更准确地预测股骨尺寸。
