Simulation Software to Plan the Treatment of Acetabular Fractures: The Patient-Specific Biomechanical Model.
Journal
Journal of orthopaedic trauma
ISSN: 1531-2291
Titre abrégé: J Orthop Trauma
Pays: United States
ID NLM: 8807705
Informations de publication
Date de publication:
01 11 2023
01 11 2023
Historique:
accepted:
08
08
2023
medline:
2
11
2023
pubmed:
13
10
2023
entrez:
13
10
2023
Statut:
ppublish
Résumé
The objective of this study was to assess the impact of using simulation software for preoperative planning: a patient-specific biomechanical model (PSBM) in acetabular surgery. The secondary objectives were to assess operating time, intraoperative bleeding, and peroperative complications. This is a prospective control study. Level 1 trauma center. Between January 2019 and December 2022, patients with operative acetabular fracture treated by the first author were prospectively enrolled. Patients were divided into 2 groups according to the use or not of PSBM for preoperative planning. When PSBM was used, data were extracted from the preoperative high-resolution computed tomography scans to build a biomechanical model implemented in a custom software [simulation (SIM group)]. When computed tomography scans were not performed in our hospital, PSBM was not feasible (non-SIM group). Radiological results, surgery duration, blood loss, and peroperative complications were recorded. Sixty-six patients were included; 26 in the PSBM group and 40 in the standard group. The 2 groups were comparable regarding fracture patterns and epidemiological data. After simulation, in the SIM group, a poor reduction (>3 mm) was found in 2 of 26 patients (7.7%) versus 11 of 40 patients (27.5%) in the non-SIM group, P = 0.048. The mean operative time was shorter after simulation (110 minutes vs. 155 minutes, P = 0.01), and the mean blood loss was reduced (420 vs. 670 mL, P = 0.01). By reducing the peroperative trials for reduction, PSBM allows better reduction in a shorter operative time and with less blood loss. Level II: prospective study.
Identifiants
pubmed: 37828697
doi: 10.1097/BOT.0000000000002689
pii: 00005131-202311001-00004
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
S18-S22Subventions
Organisme : ANR France and the Fondation pour lâ€Avenir (labex CAMI)
ID : ANR-11-LABX-0004
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose, in relation to the present study or elsewhere.
Références
Boudissa M, Courvoisier A, Chabanas M, et al. Computer assisted surgery in preoperative planning of acetabular fracture surgery: state of the art. Expert Rev Med Devices. 2018;15:81–89.
Sebaaly A, Jouffroy P, Emmanuel Moreau P, et al. Intraoperative cone beam tomography and navigation for displaced acetabular fractures: a comparative study. J Orthop Trauma. 2018;32:612–616.
Gras F, Marintschev I, Klos K, et al. Screw placement for acetabular fractures: which navigation modality (2-dimensional vs. 3-dimensional) should be used? An experimental study. J Orthop Trauma. 2012;26:466–473.
Boudissa M, Ruatti S, Kerschbaumer G, et al. Part 2: outcome of acetabular fractures and associated prognostic factors-a ten-year retrospective study of one hundred and fifty six operated cases with open reduction and internal fixation. Int Orthop. 2016;40:2151–2156.
Alfonso NA, Ryan W, Baldini T, et al. Fixation of transverse acetabular fractures with precontoured plates alone causes fracture malreduction: a biomechanical assessment. J Orthop Trauma. 2020;34:89–94.
Matta JM, Merritt PO. Displaced acetabular fractures. Clin Orthop Relat Res. 1988;230:83–97.
Boudissa M, Oliveri H, Chabanas M, et al. Computer-assisted surgery in acetabular fractures: virtual reduction of acetabular fracture using the first patient-specific biomechanical model simulator. Orthop Traumatol Surg Res. 2018;104:359–362.
Boudissa M, Bahl G, Oliveri H, et al. Virtual preoperative planning of acetabular fractures using patient-specific biomechanical simulation: a case-control study. Orthop Traumatol Surg Res. 2021;107:103004.
Boudissa M, Noblet B, Bahl G, et al. Planning acetabular fracture reduction using a patient-specific biomechanical model: a prospective and comparative clinical study. Int J Comput Assist Radiol Surg. 2021;16:1305–1317.
Yushkevich PA, Piven J, Hazlett HC, et al. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage. 2006;31:1116–1128.
Loyd J, Stavness I, Fels S. ArtiSynth: a fast interactive biomechanical modeling toolkit combining multibody and finite element simulation. In: Payan Y, eds. Soft Tissue Biomechanical Modeling for Computer Assisted Surgery. Heidelberg: Springer-Verlag Berlin; 2012. 355–394.
Letournel E. Acetabulum fractures: classification and management. Clin Orthop. 1980;151:81–106.
Cimerman M, Kristan A. Preoperative planning in pelvic and acetabular surgery: the value of advanced computerised planning modules. Injury. 2007;38:442–449.
Fornaro J, Keel M, Harders M, et al. An interactive surgical planning tool for acetabular fractures: initial results. J Orthop Surg Res. 2010;4:5–50.
Hu Y, Li H, Qiao G, et al. Computer-assisted virtual surgical procedure for acetabular fractures based on real CT data. Injury. 2011;42:1121–1124.
Xu M, Zhang LH, Zhang YZ, et al. Custom-made locked plating for acetabular fracture: a pilot study in 24 consecutive cases. Orthopedics. 2014;7:660–667.
Zeng C, Xing W, Wu Z, et al. A combination of three-dimensional printing and computer-assisted virtual surgical procedure for preoperative planning of acetabular fracture reduction. Injury. 2016;47:2223–2227.