Application value of the computer simulation technology based on 3D-CT reconstruction in the design of individualized surgery for DDH patients

ObjectiveTo explore the role of virtual surgery based on 3D-CT reconstruction in the preoperative evaluation, surgical program and postoperative evaluation of Bernese periacetabular osteotomy(PAO) in the treatment of developmental dysplasia of the hip(DDH).

MethodsThe 10 hips with DDH were reconstructed using Mimics and Imageware software, the anatomic morphological parameters of each hip were measured, and the direction of acetabular opening and location and extent of covering defect were evaluated before operation.The computer simulating operation and designing individualized surgical program provided the reference in actual operation.The results were evaluated by comparing preoperative and postoperative anatomical and morphological parameters of hip joint, and clinical function scores.

ResultsBefore operation, the average values of LCEA, ACEA, AASA and PASA in affected side were less than those in normal side(P < 0.05), and the value of AAVA in affected side was bigger than that in normal side in DDH patients(P < 0.05).Compared with before operation, the mean values of LCEA, ACEA, AAVA, and AASA in PAO patients were significantly improved after PAO surgery(P < 0.05), but the PASA decreased, and the difference of which between before and after operation was not statistically significant(P>0.05).There was no statistical significance in the postoperative LCEA, ACEA and AAVA between affected side and normal side(P>0.05).The differences of the scores of HHS and VAS between two sides in DDH patients before and after surgery were statistically significant(P < 0.05).The scores of HHS and VAS in affected side at the last follow-up were significantly improved compared with those before operation(P < 0.05).

ConclusionsThe computer simulation technology based on 3D CT reconstruction can measure the anatomical and morphological parameters of hip joint, accurately quantify the anatomic structural development deformity of DDH patients before surgery, design the individualized surgical plan to guide actual surgery, and significantly improve the imaging parameters and clinical function scores after surgery.