Innovación en artroplastía compleja de cadera (secuela de Perthes y displasia del desarrollo de cadera): utilización de modelos 3D en planificación y simulación quirúrgica. Resultados funcionales y radiográficos. Estudio piloto.

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Title:	Innovación en artroplastía compleja de cadera (secuela de Perthes y displasia del desarrollo de cadera): utilización de modelos 3D en planificación y simulación quirúrgica. Resultados funcionales y radiográficos. Estudio piloto.
Alternate Title:	Innovation in complex hip arthroplasty (Perthes sequel and developmental dysplasia of the hip): use of 3D models in surgical planning and simulation. Functional and radiographic results. Pilot study.
Authors:	Godoy-Monzón, D.¹ danigodoy@yahoo.com, Fernández Sainz-Rozas, E.¹, Pascual-Espinosa, J. M.¹, Jiménez-Baquero, J.¹
Source:	Acta Ortopédica Mexicana. Jul/Aug2025, Vol. 39 Issue 4, p212-219. 8p.
Subjects:	TOTAL hip replacement, METALS in surgery, PLASTIC surgery, COMPUTED tomography, OSSEOINTEGRATION
Abstract (English):	Introduction: anatomical deformities such as developmental dysplasia of the hip (DDH) and Perthes disease represent a challenge for reconstruction. The use of 3D-printed models can be helpful for assessing the deformity, bone mass, implant size, and orientation. Objectives: to prospectively evaluate the outcomes of 3D simulation in primary total hip arthroplasty. Material and methods: between January 2019 and March 2020, 22 patients received a trabecular titanium cup and a neck preserving stem after preoperative planning with 3D plastic models and surgery simulation. Inclusion criteria: sequelae of Perthes, hip dysplasia type I and II Crowe classification. Exclusion criteria: fractures, previous infection, remaining metal implants. Demographic data, surgery time, blood loss, and complications were recorded. Preoperative and postoperative Harris Hip Score (HHS) and subjective satisfaction using the Roles and Maudsley scale were evaluated, along with radiographic findings and Moore's criteria for osteointegration. Results: the average patient age was 35 years (range: 18-57), with 15 women and seven men. The 3D modeling process, from CT scan acquisition to final model production, took an average of 3.4 hours, and the surgery simulation lasted an average of 32 minutes. In all cases, the acetabular cup size was correct, with only one discrepancy in the femoral stem size. The average follow-up was 40.7 months. The average HHS increased from 37.5 ± 5.8 preoperatively to 90.0 ± 2.3 at the final follow-up. The average surgery time was 71 minutes, and the average blood loss was 260 ml. Complications included one case of temporary paresthesia (resolved by 50 days postoperatively), one superficial infection, and one deep infection. All components were stable at the final follow-up. Conclusions: 3D simulation allowed for accurate implant placement with significant improvement in both functional and subjective scores. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Introducción: deformidades anatómicas como la displasia del desarrollo de la cadera y la enfermedad de Perthes representan un desafío para la reconstrucción quirúrgica. La impresión de modelos 3D puede ser útil para evaluar la deformidad, la masa ósea, el tamaño y la orientación del implante. Objetivos: evaluar prospectivamente los resultados obtenidos con la simulación en 3D para cirugía de artroplastía total de cadera primaria. Material y métodos: entre Enero de 2019 y Marzo de 2020, 22 pacientes recibieron una copa de titanio trabecular y un vástago de preservación de cuello tras la creación de modelos plásticos 3D preoperatorios y simulación quirúrgica. Criterios de inclusión: secuela de Perthes, displasia del desarrollo de cadera tipo I y II de la clasificación de Crowe. Criterios de exclusión: fracturas, infección previa e implantes metálicos remanentes. Se registraron datos demográficos, tiempo de cirugía, pérdida de sangre y complicaciones, así como las puntuaciones prequirúrgicas y postquirúrgicas del Harris Hip Score (HHS) y la evaluación subjetiva de Roles y Maudsley. También se evaluaron los hallazgos radiográficos y la puntuación de osteointegración según los criterios de Moore. Resultados: la edad promedio de los pacientes fue 35 años (rango: 18-57), con 15 mujeres y siete hombres. El tiempo promedio para el proceso de modelado 3D, desde la adquisición de la tomografía computarizada hasta la producción del modelo final, fue de 3.4 horas, mientras que la simulación de la cirugía tomó un promedio de 32 minutos. En todos los casos, la copa acetabular se colocó correctamente, con solo una diferencia en el tamaño del vástago femoral. El seguimiento promedio fue 40.7 meses. El HHS aumentó, en promedio, de 37.5 ± 5.8 preoperatoriamente a 90.0 ± 2.3 en el último seguimiento. El tiempo quirúrgico promedio fue 71 minutos y la pérdida de sangre promedio fue 260 ml. Las complicaciones incluyeron un caso de parestesia temporal (recuperada a los 50 días postoperatorios), una infección superficial y una infección profunda. Todos los componentes permanecieron estables en el seguimiento final. Conclusión: la simulación en 3D permitió una correcta colocación de los implantes, con una mejora significativa en las puntuaciones funcionales y subjetivas. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Introduction: anatomical deformities such as developmental dysplasia of the hip (DDH) and Perthes disease represent a challenge for reconstruction. The use of 3D-printed models can be helpful for assessing the deformity, bone mass, implant size, and orientation. Objectives: to prospectively evaluate the outcomes of 3D simulation in primary total hip arthroplasty. Material and methods: between January 2019 and March 2020, 22 patients received a trabecular titanium cup and a neck preserving stem after preoperative planning with 3D plastic models and surgery simulation. Inclusion criteria: sequelae of Perthes, hip dysplasia type I and II Crowe classification. Exclusion criteria: fractures, previous infection, remaining metal implants. Demographic data, surgery time, blood loss, and complications were recorded. Preoperative and postoperative Harris Hip Score (HHS) and subjective satisfaction using the Roles and Maudsley scale were evaluated, along with radiographic findings and Moore's criteria for osteointegration. Results: the average patient age was 35 years (range: 18-57), with 15 women and seven men. The 3D modeling process, from CT scan acquisition to final model production, took an average of 3.4 hours, and the surgery simulation lasted an average of 32 minutes. In all cases, the acetabular cup size was correct, with only one discrepancy in the femoral stem size. The average follow-up was 40.7 months. The average HHS increased from 37.5 ± 5.8 preoperatively to 90.0 ± 2.3 at the final follow-up. The average surgery time was 71 minutes, and the average blood loss was 260 ml. Complications included one case of temporary paresthesia (resolved by 50 days postoperatively), one superficial infection, and one deep infection. All components were stable at the final follow-up. Conclusions: 3D simulation allowed for accurate implant placement with significant improvement in both functional and subjective scores. [ABSTRACT FROM AUTHOR]
ISSN:	23064102
DOI:	10.35366/120453