Abstract
Abstract
Background
Modern designs of joint replacements require a large inventory of components to be available during surgery. Pre-operative CT imaging aids 3D surgical planning and implant sizing, which should reduce the inventory size and enhance clinical outcome. We aimed to better understand the impact of the use of 3D surgical planning and Patient Specific Instrumentation (PSI) on hip implant inventory.
Methods
An initial feasibility study of 25 consecutive cases was undertaken to assess the discrepancy between the planned component sizes and those implanted to determine whether it was possible to reduce the inventory for future cases. Following this, we performed a pilot study to investigate the effect of an optimized inventory stock on the surgical outcome: we compared a group of 20 consecutive cases (experimental) with the 25 cases in the feasibility study (control). We assessed: (1) accuracy of the 3D planning system in predicting size (%); (2) inventory size changes (%); (3) intra and post-operative complications.
Results
The feasibility study showed variability within 1 size range, enabling us to safely optimize inventory stock for the pilot study. (1) 3D surgical planning correctly predicted sizes in 93% of the femoral and 89% of the acetabular cup components; (2) there was a 61% reduction in the implant inventory size; (3) we recorded good surgical outcomes with no difference between the 2 groups, and all patients had appropriately sized implants.
Conclusions
3D planning is accurate in up to 95% of the cases. CT-based planning can reduce inventory size in the hospital setting potentially leading to a reduction in costs.
Publisher
Springer Science and Business Media LLC
Subject
Computer Science Applications,Radiology, Nuclear Medicine and imaging,Biomedical Engineering
Reference37 articles.
1. Healy WL, Iorio R. Implant selection and cost for total joint arthroplasty: conflict between surgeons and hospitals. Clin Orthop Related Res. 2007;457:57–63.
2. Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. JBJS. 2005;87(7):1487–97.
3. Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Related Res. 2009;467(10):2606–12.
4. Nichols CI, Vose JG. Clinical outcomes and costs within 90 days of primary or revision total joint arthroplasty. J Arthroplasty. 2016;31(7):1400–6 e1403.
5. Barber TC, Healy WL. The hospital cost of total hip arthroplasty. A comparison between 1981 and 1990. JBJS. 1993;75(3):321–5.
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