Dataset Information

Bone Volumes and Trajectory Angles for Acetabular Anchor Placement Can Be Optimized.

ABSTRACT:

Purpose

The purpose of this study was to determine the optimal anchor placement and trajectory when repairing acetabular labral tears during hip arthroscopy with the primary focus on the 12 to 3 o'clock positions on the acetabular rim.

Methods

Three-dimensional computational models of the pelvis were generated from 13 cadaveric specimens using 3D slicer medical imaging software. A set of cones, consistent with the dimensions of a commonly used sutured anchor, were virtually embedded into the models at the 12, 1, 2, and 3 o'clock positions around the acetabulum. Mirror images of the cone were extended toward the superficial aspect of the hip. The volume of bone occupied by the virtual anchor, the trajectory angle, and the volume of overlap between adjacent anchor locations were calculated.

Results

Bone volume was significantly greater at the 1 o'clock position (4196.2 [1190.2] mm³) compared with all other positions (P < .001). The 3 o'clock position had the smallest volume (629.2 [180.0] mm³) and was also significantly less than the 12 (P < .001) and 2 o'clock (P = .014) positions). The trajectory angle of 32.04 [5.05]°) at the 1 o'clock position was significantly greater compared with all other positions (P < .001). The least amount of adjacent position overlap occurred between the 2 and 3 o'clock positions (.12 [.42] mm³), and this was statistically smaller than the overlap between cones at the 12 and 1 o'clock positions (214.28 [251.88] mm³; P = .029) and the 1 and 2 o'clock positions (139.51 [177.14] mm³; P = .044).

Conclusions

Trajectory angles and the thickness of bone around the acetabulum were the greatest at the 12 to 1 o'clock positions, with the 1 o'clock position identified as that with the largest trajectory angle for safe anchor insertion.

Clinical relevance

The use of a single, workhorse portal, for anchor insertion may not be recommended and careful selection of a portal allowing a direct approach should be used for anterior anchor insertion.

SUBMITTER: Di Loreto R

PROVIDER: S-EPMC9042773 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Bone Volumes and Trajectory Angles for Acetabular Anchor Placement Can Be Optimized.

Di Loreto Rai R Getgood Alan A Degen Ryan R Burkhart Timothy A TA

Arthroscopy, sports medicine, and rehabilitation 20211207 2

<h4>Purpose</h4>The purpose of this study was to determine the optimal anchor placement and trajectory when repairing acetabular labral tears during hip arthroscopy with the primary focus on the 12 to 3 o'clock positions on the acetabular rim.<h4>Methods</h4>Three-dimensional computational models of the pelvis were generated from 13 cadaveric specimens using 3D slicer medical imaging software. A set of cones, consistent with the dimensions of a commonly used sutured anchor, were virtually embedd ...[more]

PMID: 35494283

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Project description:BackgroundCortical bone trajectory (CBT) screws can be very reliable anchors if inserted precisely anterior to the vertebral body; however, their trajectory is narrow, and malpositioning of the screw is not rare, especially for surgeons who are not familiar with the CBT screw. Patient-specific template guides are a solution to this problem; however, their accuracy and usefulness in clinical settings remain unclear. The aim of the present study was to evaluate the accuracy of long CBT placement using a patient-specific screw-guide system.MethodsThis research involved a retrospective clinical evaluation of patients who had been enrolled prospectively. One hundred consecutive patients who underwent posterior lumbar spinal fusion using the guide system performed by three experienced spine surgeons were included. Initially, the placement of the CBT screws was mapped out in three dimensions utilizing simulation software. Prior to the surgery, a specific screw guide was designed for each vertebra. Using these guides, a total of 412 screws were placed. To assess any perforation of the pedicle and to compare the discrepancies between the intended and the actual positions of the screws, postoperative computed tomography (CT) scans were utilized.ResultsOverall, 382 screws (92.7%) were fully inside the pedicle (L2-5) and there was no incidence of neurovascular injuries. The mean depth of the screw in the vertebral body (% depth) was 60.9%±8.1% and the mean % depth deviation between planned screws and actual screw was 9.6%±7.1% in total. In all vertebrae, the mean % depth was approximately 10% smaller for the actual screws than the planned screws. The mean sagittal and transverse angular deviations between the planned screws and actual screws were 2.30±1.87° and 1.89±1.26°, respectively. Overall, deviation in the sagittal angle tended to be cranial.ConclusionsWe demonstrated that a patient-specific screw guide is useful for supporting precise long CBT screw insertion into the lumbar spine in a clinical setting. This patient-specific template guide could be a potential solution to accurately insert long CBT screws and reduce complications, even for surgeons who are not experienced in the CBT technique.

Dataset Information

Bone Volumes and Trajectory Angles for Acetabular Anchor Placement Can Be Optimized.

Purpose

Methods

Results

Conclusions

Clinical relevance

Publications

Bone Volumes and Trajectory Angles for Acetabular Anchor Placement Can Be Optimized.

Similar Datasets

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