Novel Patient-Specific Instruments for Acetabular Preparation and Cup Placement

Abstract:

Introduction: Patient-specific implants and instruments (PSI) have been used in both knee and shoulder replacements due to the perceived benefits of improved surgical accuracy and efficiency. The proposed benefits of using a PSI in total hip arthroplasty (THA) are numerous and include reduction of operative time and improved mechanical and anatomical alignment leading to increased implant longevity, increased stability, and clinical outcomes. We describe a novel patient-specific instrumentation and a surgical method that may improve directed resection of acetabular bone and accurate cup placement during THA. Materials and Methods: In this cadaveric study, 14 acetabuli were used. Pre-operative CT or MRI scans were obtained as part of the acetabular jigs Bullseye Hip Replacement Instruments® (Bullseye Hip Replacement, LLC, Las Vegas, Nevada) protocol. Two senior hip surgeons performed all the operations in accordance to the PSI technique. Post-operative CT scans were obtained and acetabular cup orientation was measured by two independent radiologists. Results: Fourteen acetabuli were implanted using the Bullseye Hip Replacement Instruments®. Acetabular cup anteversion angle as measured on post-operative CT images averaged, for all 14 acetabuli, 15.50. Acetabular cup abduction/inclination angle as measured on post-operative CT images averaged 35.9°. All implanted components' size/diameter matched the preoperative surgical planned implant size. Conclusion: The Bullseye Hip Replacement Instruments® show good reproducible acetabular cup placement in both anteversion and abduction angles, and accurate sizing of the acetabular component.

Authors:

Ran Schwarzkopf, MD, MSc, Orthopaedic Surgeon, Department of Orthopaedic Surgery, NYU Langone Medical Center Hospital for Joint Diseases, New York, New York, Erik Schnaser, MD, Orthopaedic Surgeon, Desert Orthopedic Center, Eisenhower Medical Center, Rancho Mirage, California, Taiki Nozaki, MD, Radiologist, Department of Radiological Sciences, University of California, Irvine, Orange, California, Yasuhito Kaneko, MD, Radiologist, Department of Radiological Sciences, University of California, Irvine, Orange, California, Michael J. Gillman, MD, Orthopaedic Surgeon, Restore Orthopedics Orange, Orange, California

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