Applying 3D technology to replace a man’s hip joint

Mr. Frederik was transferred to Tam Anh General Hospital in Ho Chi Minh City for surgery after a fall two weeks ago. MSc.BSc.CKI Le Dinh Khoa, Head of the Joint Reconstruction Department, Orthopedic Trauma Center, said that the patient’s right femur head was fractured and displaced a lot, the muscles in the hip joint area contracted due to limited movement, had a lot of pain and could not walk on their own. The surgery is very challenging because the patient is tall and the joint anatomy is different from Asians, so it is necessary to choose an artificial joint of the appropriate size. He also suffered from many underlying diseases such as hypertension and diabetes, so he was susceptible to complications during surgery.

After the consultation, the doctors simultaneously used many advanced 3D technologies to prepare for the surgery. The doctor prescribed a 3D CT scan of more than 100,000 slices to create a detailed three-dimensional image of the hip joint, comprehensively observe the bone and joint structure and detect potential damage. With this technology, the radiation dose of each scan is very low, only equal to an X-ray but still produces a complete bone image, supporting diagnosis and treatment.

Next, the doctor simultaneously used two specialized software in orthopedic surgery, TraumaCAD and MediCAD 3D, to increase accuracy when choosing an artificial hip joint. TraumaCAD analyzes joint structures based on X-ray images, while MediCAD 3D plans surgery based on 3D image data from CT films. These software allow doctors to locate detailed anatomical structures, calculate the tilt of the acetabulum, the direction of placing the artificial hip joint, simulate joint movement… From there, the doctor chooses the right joint for the patient’s body and plans the surgery with high accuracy.

Doctor Khoa conducted experimental “virtual” surgery, using 3D printing technology to create a hip joint model with 1:1 dimensions like a real joint, helping to predict situations that may occur during surgery and plan quick treatment, shortening the actual surgery time.

The surgeon replaces the hip joint using an anterolateral ABMS (Anterior Based Muscle Sparing) incision, which allows going deep inside and replacing the hip joint without cutting the muscle. After surgery, the muscles around the joint are preserved intact, the patient has less pain, recovers faster, avoids the risk of dislocation and nerve damage, post-operative paralysis, and can perform difficult movements after joint replacement such as squatting, crossing the legs…

On the first day after surgery, he had significant pain relief, could stand up and exercise with a walker, and both leg lengths were equal. After 2 weeks of follow-up examination, the patient recovered almost completely and walked without assistance.

According to Dr. Khoa, the femoral neck is a special structure, located deep in the hip joint, prone to lack of blood supply, so it cannot heal itself when broken, especially in the elderly. Surgery is often the optimal treatment. Doctors recommend that as soon as an injury occurs, patients should go to hospitals specializing in musculoskeletal or orthopedic injuries for timely treatment and to avoid complications.