The use of 3D printed models for the pre-operative planning of surgical correction of pediatric hip deformities: a case series and concise review of the literature.

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Giulia Facco
Daniele Massetti
Valentino Coppa
Roberto Procaccini
Luciano Greco
Michela Simoncini
Alberto Mari
Mario Marinelli
Antonio Gigante


3D printing, surgical planning, Zanoli-Pemberton osteotomy, Ganz-Paley osteotomy, mock surgery


Background and aim: Three-dimensional (3D) printing is prevailing in surgical planning of complex cases. The aim of this study is to describe the use of 3D printed models during the surgical planning for the treatment of four pediatric hip deformity cases. Moreover, pediatric pelvic deformities analyzed by 3D printed models have been object of a concise review.

Methods: All treated patients were females, with an average age of 5 years old. Patients’ dysplastic pelvises were 3D-printed in real scale using processed files from Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). Data about 3D printing, surgery time, blood loss and fluoroscopy have been recorded.

Results: The Zanoli-Pemberton or Ganz-Paley osteotomies were performed on the four 3D printed models, then the real surgery was performed in the operating room. Time and costs to produce 3D printed models were respectively on average 17:26 h and 34.66 €. The surgical duration took about 87.5 min while the blood loss average was 1.9 ml/dl. Fluoroscopy time was 21 sec. MRI model resulted inaccurate and more difficult to produce. 10 papers have been selected for the concise literature review.

Conclusions: 3D printed models have proved themselves useful in the reduction of surgery time, blood loss and ionizing radiation, as well as they have improved surgical outcomes. 3D printed model is a valid tool to deepen the complex anatomy and orientate surgical choices by allowing surgeons to carefully plan the surgery.


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1. Caffrey JP, Jeffords ME, Farnsworth CL, Bomar JD, Upasani VV. Comparison of 3 Pediatric Pelvic Osteotomies for Acetabular Dysplasia Using Patient-specific 3D-printed Models. J Pediatr Orthop 2019; 39(3):e159–e164.
2. Murphy RF, Kim YJ. Surgical Management of Pediatric Developmental Dysplasia of the Hip. J Am Acad Orthop Surg 2016; 24(9):615–624.
3. Coppa V, Marinelli M, Specchia N. Unilateral uniplanar modular external fixator for percutaneous proximal femoral osteotomy in children: surgical technique. Eur J Orthop Surg Traumatol 2019; 29(1):205–211.
4. Baki ME, Baki C, Aydin H, Ari B, Özcan M. Single-stage medial open reduction and Pemberton acetabuloplasty in developmental dysplasia of the hip. J Pediatr Orthop B 2016; 25(6):504–508.
5. Paley D., Feldman D.S. Femoral Head Reduction Osteotomy. In: Saran N. Hamdy R.C. Pediatric Pelvic and Proximal Femoral Osteotomies: a case-based approach, Springer, 2018; 379-420
6. Hamdy R.C., Epstein D.S. Preoperative Planning for Pelvic and/or Proximal Femoral Osteotomies. In: Saran N. Hamdy R.C. Pediatric Pelvic and Proximal Femoral Osteotomies: A Case-Based Approach, Springer, 2018; 1-11.
7. Iobst CA. New Technologies in Pediatric Deformity Correction. Orthop Clin North Am 2019; 50(1):77–85.
8. Liu X, Dong K, Zheng S, et al. Separation of pygopagus, omphalopagus, and ischiopagus with the aid of three-dimensional models. J Pediatr Surg 2018; 53(4):682–687.
9. Cho J, Park CS, Kim YJ, Kim KG. Clinical Application of Solid Model Based on Trabecular Tibia Bone CT Images Created by 3D Printer. Healthc Inform Res 2015; 21(3):201-5.
10. Wei YP, Lai YC, Chang WN. Anatomic three-dimensional model-assisted surgical planning for treatment of pediatric hip dislocation due to osteomyelitis. J Int Med Res 2019; 300060519854288.
11. Zheng P, Yao Q, Xu P, Wang L. Application of computer-aided design and 3D-printed navigation template in Locking Compression Pediatric Hip PlateTM placement for pediatric hip disease. Int J Comput Assist Radiol Surg 2017; 12(5):865-871.
12. Hedelin H, Swinkels CS, Laine T, Mack K, Lagerstrand K. Using a 3D Printed Model as a Preoperative Tool for Pelvic Triple Osteotomy in Children: Proof of Concept and Evaluation of Geometric Accuracy. J Am Acad Orthop Surg Glob Res Rev 2019; 3(3):e074.
13. Cherkasskiy L, Caffrey JP, Szewczyk AF, et al. Patient-specific 3D models aid planning for triplane proximal femoral osteotomy in slipped capital femoral epiphysis. J Child Orthop 2017;11(2):147–153.
14. Kalenderer Ö, Erkuş S, Turgut A, İnan İH. Preoperative planning of femoral head reduction osteotomy using 3D printing model: A report of two cases. Acta Orthop Traumatol Turc 2019; 53(3):226–229.
15. Cai Z, Zhao Q, Li L, Zhang L, Ji S. Can. Computed Tomography Accurately Measure Acetabular Anterversion in Developmental Dysplasia of the Hip? Verification and Characterization Using 3D Printing Technology. J Pediatr Orthop 2018; 38(4):e180–e185.
16. Ventola, C L. Medical Applications for 3D Printing: Current and Projected Uses. P.T 2014; 39(10):704–711.
17. Curodeau A, Sachs E, Caldarise S. Design and fabrication of cast orthopedic implants with freeform surface textures from 3-D printed ceramic shell. J Biomed Mater Res 2000; 53(5):525–535.
18. Holt AM, Starosolski Z, Kan JH, Rosenfeld SB. Rapid Prototyping 3D Model in Treatment of Pediatric Hip Dysplasia: A Case Report. Iowa Orthop J 2017; 37:157–162.
19. Tack P, Victor J, Gemmel P, Annemans L. 3D printing techniques in a medical setting: a systematic literature review. Biomed Eng Online 2016; 15:115.
20. Chen C, Cai L, Zheng W, Wang J, Guo X, Chen H. The efficacy of using 3D printing models in the treatment of fractures: a randomised clinical trial. BMC Musculoskelet Disord 2019; 20(1):65.
21. Zheng P, Xu P, Yao Q, Tang K, Lou Y. 3D-printed navigation template in proximal femoral osteotomy for older children with developmental dysplasia of the hip. Sci Rep 2017; 7:44993.
22. Tsukagoshi Y, Kamada H, Takeuchi R, et al. Three-dimensional MRI analyses of prereduced femoral head sphericity in patients with developmental dysplasia of the hip after Pavlik harness failure. J Pediatr Orthop B 2018; 27(5):394–398.
23. Arezoomand S, Lee WS, Rakhra KS, Beaulé PE. A 3D active model framework for segmentation of proximal femur in MR images. Int J Comput Assist Radiol Surg 2015; 10(1):55–66.
24. Wadhwa V, Malhotra V, Xi Y, Nordeck S, Coyner K, Chhabra A. Bone and joint modeling from 3D knee MRI: feasibility and comparison with radiographs and 2D MRI. Clin Imaging 2016; 40(4), 765–768.
25. Brochard S, Mozingo JD, Alter KE, Sheehan FT. Three dimensionality of gleno-humeral deformities in obstetrical brachial plexus palsy. J Orthop Res 2016; 34(4):675–682.
26. Wells J, Nepple JJ, Crook K, et al. Femoral Morphology in the Dysplastic Hip: Three-dimensional Characterizations With CT. Clin Orthop Relat Res 2017; 475(4):1045–1054.
27. Zheng P, Yao Q, Xu P, Tang K, Chen J, Li Y, et al. Application of three dimensional printed navigation template in pediatric femoral neck fracture. Digit Med 2016; 2:113 9.

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