| Objective:1. To measure the three-dimensional anatomy parameters of the patients who have acetabular dysplasia, providing theoretical basis for preoperative planning.2. To investigate the feasibility of the navigation template in Bernese Periacetabular Osteotomy(PAO).3. To investigate the treatment effect of PAO assisted by individual navigation templates.Methods:1. We analysed 34 cases patients (68 hips) with acetabulum dysplasia retrospectively and reconstructed three-dimensional model of the pelvis and femur, all of the parameters were calculated and analysed precisely by the software.2. We collected 5 adult cadaveric specimens (10 hips) raw CT data preoperatively and reconstructed 3D anatomical model with the Mimics 10.01. The individual navigation templates was designed in Geomagic Studio 11.0 software. The physical navigational templates was build using a rapid prototyping (RP) technique to assist cadaveric Bernese Periacetabular osteotomy. CT scans and pelvic plain film were performed postoperatively to evaluate accuracy of PAO assisted by individual navigation templates.3.26 cases of acetabular dysplasia were admitted. The navigation templates was designed according to individualized anatomic abnormalities with the Materials Mimics and Geomagic Studio software. The amount and orientation of osteotomy was determined according to the templates in the operation. All postoperative parameters were proceeded analysis statistically compared to preoperative parameters.Results:1. The mean the wiberg lateral center-edge angle was (4.28±9.43)°, the mean acetabular index angle was (28.84±9.99), the mean femoral head extrusion index was (44.03±9.27)%, the mean acetabulum abducent angles was (36.45±4.08) °. the mean anterior coverage was (9.24±7.09)%, the mean posterior coverage was (42.14±14.54)%, there was not significant differences in between X-ray and 3d measurement. The mean total femoral coverage and acetabular anteversion angle of normal hip was (79.36±4.46)%and (17.37±4.32) ° respectively, the mean total femoral coverage and acetabular anteversion angle of abnormal hip was (55.25± 10.99)% and (25.02±8.21)°respectively. The mean femoral neck anteversion angle of 3d measurement was (26.18±15.21)°and the mean femoral neck anteversion angle of X-ray measurement was (27.83±11.69)°2. In the cadaver specimen, template is attached onto the internal surface of the pelvis well; We finish acetabulum bone cutting and rotation according to the template precisely; indicators was no statistically significant difference between computer simulation and postoperative.3. The present study applies 3D printing navigation template technology in the PAO performed on 26 cases (26 hips) with AD. indicators was no statistically significant difference between computer simulation and postoperative (P> 0.05);No cases were reported of such complications as intraarticular osteotomy, no sciatic nerve and femoral nerve damage and other serious complications; All osteotomies don’t need to be completed in fluoroscopy.Conclusion:1. The shape of acetabulum dysplasia in patients with hip is complex and individual differences of the parameters is large, Three-dimensional reconstruction techniques can well display pathological anatomy of the hip. Accurate anatomical measurement provide the basis for surgical planning.2. The navigation template can acquire accurate periacetabular osteotomy and rotation of the acetabular fragment, achieving the purpose of accurate guide practical operation.3. Individual navigation templates assisted PAO can improve surgical accuracy, reduce the major complications of the surgery, and reduce the frequency of intraoperative fluoroscopy. |
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