Journal of Aesthetic & Reconstructive Surgery

Description

Surgical techniques are used to rebuild the stabilization of an injured pelvis using a plate/screw fixation structure for pelvic bone reduction. Pelvic symmetry is taken for granted as a surgical rule when creating a patient-specific repair model for the injured pelvic bone in terms of the contralateral geometric shape. Due to the geometric and anatomic complexity of the pelvis, morphological symmetry might be clinically beneficial in the design and 3D-printing fabrication of a customized fixation plate. Furthermore, several studies employed the concept of morphological symmetry of the pelvic ring to evaluate the reduction grade of injured pelvic bones, such as Sagi's inlet/outlet ratio10 and Lefaivre's cross measurement.

Total Hip Arthroplasty

Image segmentation was performed using the bone automatically segmentation tool and split mask tool on Mimics. Mimics then reconstructed 3D models of pelvises and saved them into STL file format for export into Geomagic Studio software for further smoothing those models for digital analysis. In this study, the pelvic ring model referred to two hip bones without covering the sacrum model since the morphological analysis targeted the symmetrical features of the alignment of hip bones. Total Hip Arthroplasty (THA) has been one of the most successful surgeries in the 20th century and has been used for easing pain, correcting deformity, and improving hip joint function.

The most common and serious complication is femoral head necrosis. The main cause of traumatic femoral head necrosis is the destruction of the femoral head blood supply. The femoral head is supplied by three groups of blood vessels: the superior, inferior, and anterior retinacula arteries. When femoral neck fractures occur, some of the blood vessels are usually damaged, which leads to avascular necrosis of the femoral head.

It is calculated based on the patient's medical history, prognosis and weighted age. CT can be used to observe the degree of fracture displacement from a three-dimensional perspective. Because the retinacula are all attached to the femoral neck surface, accurate judgment of the degree of fracture displacement can lead to an indirect inference of the damage to the retinacular blood vessels.

. However, the optimal management of nondisplaced elderly femoral neck fractures remains controversial. Though arthroplasty had several advantages, such as improved mobility and fewer major reoperations, it was reported that there was no significant difference between internal fixation and arthroplasty in long-term mortality and reestablishing hip functions. Besides, the result of a successful hip replacement is not exactly equivalent to a united femoral neck fracture, especially in Chinese elderly patients who like squatting or sitting cross-legged.

Hip Center of Rotation

The management of severe acetabular bone defects in primary or revision THA is challenging and the ideal reconstruction of the defect represents one of the critical factors for a successful THA. The basic principles of acetabular defect reconstruction include restoring Hip Center of Rotation (HCOR). Then, a nylon pelvis model was printed to simulate operation with the surgeons. At this time, the augment was designed and modified according to the surgeon's suggestions and the 3D printing principles. Eighteen patients with Paprosky type III acetabular defects receiving reconstructive surgery by 3D printed porous augments were included in current study.

Each designs and methods has various success rates as well as various complication rates. Recently, given the excellent biocompatibility and biomechanical properties of TM, TM augments and cups are most commonly employed and they yielded good clinical mid-term outcomes. Since TM augments are mass-produced in standard sizes and shapes, they do not always fit in with the morphology of acetabular bone defects, and reaming the residual bone stock of acetabula defects is required in most cases.

The HHS score system mainly includes four aspects as pain, function, absence of deformity, and range of motion. The score standard had a maximum of 100 points (best possible outcome). Gender, type of Paprosky acetabular bone defect, and radiological loosening or radiolucent lines of the acetabular components and augments were of a categorical nature. Age, Body Mass Index (BMI), preoperative laboratory examination, LLD, HCOR vertical position, and HHS were numerical data.

Rates were compared by using chi-squared test while numerical data were compared by employing paired sample t test (normal distribution and homoscedasticity) or Wilcoxon rank test. The influence of porosity, pore size, and pore shape on the biological behaviors of porous Ti6Al4V prosthesis has been previously investigated. Heinl et al. demonstrated that three-dimensional structures with a mean interconnected porosity of 61.3% and pore size of 450 μm were suitable for tissue ingrowth and vascularization. They also demonstrated that the cubic design had the lowest elastic modulus and could lead to the fastest new bone formation. Another study investigated the influence of the pore shape on mechanical properties and showed that the cubic scaffold was conductive to osseo integration and tissue integration. Considering that the surface of severely defective acetabular bone was not entirely cancellous, the defect surface of many patients receiving revision THA would be partially corticalized due to long-term wear.

Important features of SuperPATH are the following: operating the hip in situ with the lower extremity rested on a Mayo stand during the entire operation; tissue-sparing technique through the interval between m. gluteus medius and m. piriformis; preservation of the capsule; percutaneous accessory portal for acetabular preparation for un-obscured visualization. This is an overview of the conventional approaches (anterior, anterolateral, lateral transgluteal, lateral transtrochanteric, posterior, and posterolateral) to the hip joint and a more detailed description of SuperPATH. Meta-SuCAs-2 measured the following outcome parameters according to their importance. Primary outcomes were the intraoperative blood loss in ml, Harris hip score (HHS) in points, and postoperative complications such as hip dislocation, periprosthetic fracture, infection, deep vein thrombosis, and haematoma.