The Experts below are selected from a list of 16479 Experts worldwide ranked by ideXlab platform
Eduardo A Salvati - One of the best experts on this subject based on the ideXlab platform.
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the utility and precision of analogue and digital Preoperative Planning for total hip arthroplasty
International Orthopaedics, 2008Co-Authors: Alejandro Gonzalez Della Valle, Fernando Comba, Nicole Taveras, Eduardo A SalvatiAbstract:We prospectively compared the utility and precision of Preoperative templating performed in printed films (analogue) with that performed on digital radiographs (digital) in 69 patients undergoing primary total hip replacement. Five patients were excluded when misplacement of the marker resulted in a magnification error greater that 10%; in the remaining patients (64 hips), the cup size was within ± one size in 62 (97%) of the analogue and 52 (81%) of the digital (p = 0.01) plans. The stem size was within ± one size in 63 (98%) of the analogue and 60 (94%) of the digital (p = 0.39) plans. The distance from the proximal corner of the lesser trochanter to the center of the prosthetic head (LTCD) in the analogue differed by 5 mm or more from the digital plan in nine cases (14%). Analogue Preoperative Planning yielded more predictable results than digital Planning, particularly in terms of acetabular component size and LTCD that dictates limb lengthening-shortening. The sources of error were not clearly explained by variations in magnification. Inconsistent positioning of the magnification marker may jeopardise the safe implementation of digital templating.
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Preoperative Planning for primary total hip arthroplasty
Journal of The American Academy of Orthopaedic Surgeons, 2005Co-Authors: Alejandro Gonzalez Della Valle, Douglas E Padgett, Eduardo A SalvatiAbstract:Preoperative Planning is of paramount importance in obtaining reproducible results in modern hip arthroplasty. Planning helps the surgeon visualize the operation after careful review of the clinical and radiographic findings. A standardized radiograph with a known magnification should be used for templating. The cup template should be placed relative to the ilioischial line, the teardrop, and the superolateral acetabular margin, so that the removal of the supportive subchondral bone is minimal and the center of rotation of the hip is restored. When acetabular abnormalities are encountered, additional measures are necessary to optimize cup coverage and minimize the risk of malposition. Templating the femoral side for cemented and cementless implants should aim to optimize limb length and femoral offset, thereby improving the biomechanics of the hip joint. Meticulous Preoperative Planning allows the surgeon to perform the procedure expediently and precisely, anticipate potential intraoperative complications, and achieve reproducible results.
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the precision and usefulness of Preoperative Planning for cemented and hybrid primary total hip arthroplasty
Journal of Arthroplasty, 2005Co-Authors: Alejandro Gonzalez Della Valle, Gaston Slullitel, Francisco Piccaluga, Eduardo A SalvatiAbstract:We evaluated the utility of a Preoperative Planning technique with a review of Preoperative radiographs, templates, plans, charts and 6-week postoperative radiographs of 139 total hip arthroplasties (THAs) (116 cemented and 23 hybrid) to determine size, orientation of the implants, and cement column mantle, location of the planned and achieved center of rotation, and limb-length discrepancy. The acetabular component size was predicted exactly in 116 hips (83%) (within +/-1 size in 138 hips [99%]); the femoral component size was predicted exactly in 108 hips (78%) (within +/-1 size in 138 [99%]). In 75 arthroplasties (45%), the center of rotation was within 2 mm of horizontal and vertical distance from the plan, and in 127 (91%) arthroplasties, it was within 4 mm. The inclination of the cup averaged 44 degrees (range, 30 degrees -58 degrees ). The stem was in a neutral alignment in 122 hips (88%), varus in 11 hips (8%), and in 2 degrees of valgus in 6 hips (4%). In 103 arthroplasties with a normal contralateral hip or a THA, the average limb-length discrepancy was 1.71 mm. Preoperative Planning is useful to predict the implant size, position, and alignment, to restore the center of rotation, and to equalize limb length.
Andrea Pietrabissa - One of the best experts on this subject based on the ideXlab platform.
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from ct scanning to 3 d printing technology for the Preoperative Planning in laparoscopic splenectomy
Surgical Endoscopy and Other Interventional Techniques, 2016Co-Authors: Andrea Pietrabissa, Stefania Marconi, Andrea Peri, Luigi Pugliese, Emma Cavazzi, Alessio Vinci, Marta Botti, Ferdinando AuricchioAbstract:Three-dimensional printing technology is rapidly changing the way we produce all sort of objects, having also included medical applications. We embarked in a pilot study to assess the value of patient-specific 3-D physical manufacturing of spleno-pancreatic anatomy in helping during patient’s counseling and for Preoperative Planning. Twelve patients scheduled for a laparoscopic splenectomy underwent contrast CT and subsequent post-processing to create virtual 3-D models of the target anatomy, and 3-D printing of the relative solid objects. The printing process, its cost and encountered problems were monitored and recorded. Patients were asked to rate the value of 3-D objects on a 1–5 scale in facilitating their understanding of the proposed procedure. Also 10 surgical residents were required to evaluate the perceived extra value of 3-D printing in the Preoperative Planning process. The post-processing analysis required an average of 2; 20 h was needed to physically print each model and 4 additional hours to finalize each object. The cost for the material employed for each object was around 300 euros. Ten patients gave a score of 5, two a score of 4. Six residents gave a score of 5, four a score of 4. Three-dimensional printing is helpful in understanding complex anatomy for educational purposes at all levels. Cost and working time to produce good quality objects are still considerable.
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value of multidetector computed tomography image segmentation for Preoperative Planning in general surgery
Surgical Endoscopy and Other Interventional Techniques, 2012Co-Authors: Vincenzo Ferrari, Andrea Pietrabissa, Marina Carbone, C Cappelli, Luigi Boni, Franca Melfi, Mauro Ferrari, Franco MoscaAbstract:Background Using practical examples, this report aims to highlight the clinical value of patient-specific three-dimensional (3D) models, obtained segmenting multidetector computed tomography (MDCT) images, for Preoperative Planning in general surgery.
Wenhua Huang - One of the best experts on this subject based on the ideXlab platform.
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A combination of three-dimensional printing and computer-assisted virtual surgical procedure for Preoperative Planning of acetabular fracture reduction
Injury, 2016Co-Authors: Canjun Zeng, Weirong Xing, Zhanglin Wu, Huajun Huang, Wenhua HuangAbstract:Objective Treatment of acetabular fractures remains one of the most challenging tasks that orthopaedic surgeons face. An accurate assessment of the injuries and Preoperative Planning are essential for an excellent reduction. The purpose of this study was to evaluate the feasibility, accuracy and effectiveness of performing 3D printing technology and computer-assisted virtual surgical procedures for Preoperative Planning in acetabular fractures. We hypothesised that more accurate Preoperative Planning using 3D printing models will reduce the operation time and significantly improve the outcome of acetabular fracture repair. Methods Ten patients with acetabular fractures were recruited prospectively and examined by CT scanning. A 3-D model of each acetabular fracture was reconstructed with MIMICS14.0 software from the DICOM file of the CT data. Bone fragments were moved and rotated to simulate fracture reduction and restore the pelvic integrity with virtual fixation. The computer-assisted 3D image of the reduced acetabula was printed for surgery simulation and plate pre-bending. The postoperative CT scan was performed to compare the consistency of the Preoperative Planning with the surgical implants by 3D-superimposition in MIMICS14.0, and evaluated by Matta's method. Results Computer-based pre-operations were precisely mimicked and consistent with the actual operations in all cases. The pre-bent fixation plates had an anatomical shape specifically fit to the individual pelvis without further bending or adjustment at the time of surgery and fracture reductions were significantly improved. Seven out of 10 patients had a displacement of fracture reduction of less than 1 mm; 3 cases had a displacement of fracture reduction between 1 and 2 mm. Conclusions The 3D printing technology combined with virtual surgery for acetabular fractures is feasible, accurate, and effective leading to improved patient-specific Preoperative Planning and outcome of real surgery. The results provide useful technical tips in Planning pelvic surgeries.
Alejandro Gonzalez Della Valle - One of the best experts on this subject based on the ideXlab platform.
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the utility and precision of analogue and digital Preoperative Planning for total hip arthroplasty
International Orthopaedics, 2008Co-Authors: Alejandro Gonzalez Della Valle, Fernando Comba, Nicole Taveras, Eduardo A SalvatiAbstract:We prospectively compared the utility and precision of Preoperative templating performed in printed films (analogue) with that performed on digital radiographs (digital) in 69 patients undergoing primary total hip replacement. Five patients were excluded when misplacement of the marker resulted in a magnification error greater that 10%; in the remaining patients (64 hips), the cup size was within ± one size in 62 (97%) of the analogue and 52 (81%) of the digital (p = 0.01) plans. The stem size was within ± one size in 63 (98%) of the analogue and 60 (94%) of the digital (p = 0.39) plans. The distance from the proximal corner of the lesser trochanter to the center of the prosthetic head (LTCD) in the analogue differed by 5 mm or more from the digital plan in nine cases (14%). Analogue Preoperative Planning yielded more predictable results than digital Planning, particularly in terms of acetabular component size and LTCD that dictates limb lengthening-shortening. The sources of error were not clearly explained by variations in magnification. Inconsistent positioning of the magnification marker may jeopardise the safe implementation of digital templating.
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Preoperative Planning for primary total hip arthroplasty
Journal of The American Academy of Orthopaedic Surgeons, 2005Co-Authors: Alejandro Gonzalez Della Valle, Douglas E Padgett, Eduardo A SalvatiAbstract:Preoperative Planning is of paramount importance in obtaining reproducible results in modern hip arthroplasty. Planning helps the surgeon visualize the operation after careful review of the clinical and radiographic findings. A standardized radiograph with a known magnification should be used for templating. The cup template should be placed relative to the ilioischial line, the teardrop, and the superolateral acetabular margin, so that the removal of the supportive subchondral bone is minimal and the center of rotation of the hip is restored. When acetabular abnormalities are encountered, additional measures are necessary to optimize cup coverage and minimize the risk of malposition. Templating the femoral side for cemented and cementless implants should aim to optimize limb length and femoral offset, thereby improving the biomechanics of the hip joint. Meticulous Preoperative Planning allows the surgeon to perform the procedure expediently and precisely, anticipate potential intraoperative complications, and achieve reproducible results.
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the precision and usefulness of Preoperative Planning for cemented and hybrid primary total hip arthroplasty
Journal of Arthroplasty, 2005Co-Authors: Alejandro Gonzalez Della Valle, Gaston Slullitel, Francisco Piccaluga, Eduardo A SalvatiAbstract:We evaluated the utility of a Preoperative Planning technique with a review of Preoperative radiographs, templates, plans, charts and 6-week postoperative radiographs of 139 total hip arthroplasties (THAs) (116 cemented and 23 hybrid) to determine size, orientation of the implants, and cement column mantle, location of the planned and achieved center of rotation, and limb-length discrepancy. The acetabular component size was predicted exactly in 116 hips (83%) (within +/-1 size in 138 hips [99%]); the femoral component size was predicted exactly in 108 hips (78%) (within +/-1 size in 138 [99%]). In 75 arthroplasties (45%), the center of rotation was within 2 mm of horizontal and vertical distance from the plan, and in 127 (91%) arthroplasties, it was within 4 mm. The inclination of the cup averaged 44 degrees (range, 30 degrees -58 degrees ). The stem was in a neutral alignment in 122 hips (88%), varus in 11 hips (8%), and in 2 degrees of valgus in 6 hips (4%). In 103 arthroplasties with a normal contralateral hip or a THA, the average limb-length discrepancy was 1.71 mm. Preoperative Planning is useful to predict the implant size, position, and alignment, to restore the center of rotation, and to equalize limb length.
Michael P Chae - One of the best experts on this subject based on the ideXlab platform.
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3d printed haptic reverse models for Preoperative Planning in soft tissue reconstruction a case report
Microsurgery, 2015Co-Authors: Michael P Chae, Frank Lin, Robert T Spychal, David J HuntersmithAbstract:In reconstructive surgery, Preoperative Planning is essential for optimal functional and aesthetic outcome. Creating a three-dimensional (3D) model from two-dimensional (2D) imaging data by rapid prototyping has been used in industrial design for decades but has only recently been introduced for medical application. 3D printing is one such technique that is fast, convenient, and relatively affordable. In this report, we present a case in which a reproducible method for producing a 3D-printed “reverse model” representing a skin wound defect was used for flap design and harvesting. This comprised a 82-year-old man with an exposed ankle prosthesis after serial soft tissue debridements for wound infection. Soft tissue coverage and dead-space filling were planned with a composite radial forearm free flap (RFFF). Computed tomographic angiography (CTA) of the donor site (left forearm), recipient site (right ankle), and the left ankle was performed. 2D data from the CTA was 3D-reconstructed using computer software, with a 3D image of the left ankle used as a “control.” A 3D model was created by superimposing the left and right ankle images, to create a “reverse image” of the defect, and printed using a 3D printer. The RFFF was thus planned and executed effectively, without complication. To our knowledge, this is the first report of a mechanism of calculating a soft tissue wound defect and producing a 3D model that may be useful for surgical Planning. 3D printing and particularly “reverse” modeling may be versatile options in reconstructive Planning, and have the potential for broad application. V C 2014 Wiley Periodicals, Inc. Microsurgery 00:000–000, 2014. For optimal restoration of function and appearance in reconstructive surgery, an accurate anatomical understanding of the defect is required. To this effect, Preoperative Planning with appropriate imaging techniques benefits both the excisional and reconstructive surgeon. 1‐5 Computed tomographic angiography (CTA) is one technique that has previously shown to improve operative outcomes while minimizing donor site morbidity. 6,7 It can aid in selecting the donor site, flap and vessel of choice for reconstruction. 5 Furthermore, CTA is a relatively straightforward procedure. 8 A number of investigators have proven its efficacy in reducing operative time and reconstructive outcomes. 4,6,7,9‐11
