Digital preoperative planning of total hip arthroplasty

摘要

Preoperative templating of total hip arthroplasty consists of determining the magnification of the hip on a radiograph and applying identical magnification to the radiograph and the template. The traditional planning relies on visually comparing acetate templates and analogue radiographs over a white light-box. When it is done manually, a template may be inaccurately selected and it must be corrected in the operation theatre, in this case a new prosthesis have to be ordered meanwhile the patient is under anaesthesia. Preoperative planning of total hip arthroplasty may be supported by computer technology in order to reduce the planning errors. The automation of arthroplasty requires a precise calibration for adjusting to the real dimensions in order to use templates in PDF format. In this paper, HipOrtho a digital preoperative planning of total hip arthroplasty is presented, as an open source plugin on OsiriX. HipOrtho Pluging is developed using OsiriX viewer as a tool that uses multiple libraries for rendering, DICOM management and plugins. The plugin architecture is expanded to other orthopaedic plugins, such as Osteotomy and Knee Replacement. Preliminary evaluations have been conducted using Exactech templates and digital radiographs obtained from patients at the Imbanaco Medical Centre. Currently, the plugin is under evaluation by a group of orthopaedists at the Imbanaco Medical Centre in Cali.