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Beitragstitel 3D Printing of MR-based 3D-models for SCFE patients for patient-specific preoperative planning of modified Dunn procedure
Beitragscode P49
Autoren
  1. Tilman Kaim STS AG Thun Vortragender
  2. Till Lerch Department of Diagnostic-, Interventional- and Pediatric Radiology. Inselspital, University of Bern, Bern, Switzerland Vortragender
  3. Markus Hanke Inselspital, Bern University Hospital, University of Bern
  4. Simon D. Steppacher Department of orthopedic surgery, Inselspital Bern, University of Bern, Switzerland
  5. Eduardo Novais Children's Hospital Boston, Harvard Medical School
  6. Jasmin D. Busch Inselspital, Bern University Hospital, University of Bern
  7. Kai Ziebarth Clinic for Pediatric Surgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
Präsentationsform Poster
Themengebiete
  • A07 - Spezialgebiet 1 | Kinder
Abstract Objectives
Slipped capital femoral epiphyses (SCFE) is a common pediatric hip disease with the risk of osteoarthritis and impingement deformities. MRI-based 3D-models would offer radiation-free patient-specific preoperative planning.
Therefore, we investigated (1)bone segmentation (2)feasibility of 3D-printing and of 3D impingement-simulation using MRI 3D-models and (3)short-term clinical followup.

Methods
A retrospective study involving of 10 symptomatic patients (10 hips) with SCFE was performed. Mean age was 13±2 years(50% male patients). Six patients had severe SCFE(four had moderate SCFE). All patients underwent preoperative hip MR(2016-2019) with pelvic coronal high-resolution images(T1 Starvibe). Slice thickness was 1.2mm. Semi-automatic MRI-based 3D segmentation (software AMIRA) and 3D-printing of plastic 3D-models was performed. The virtual 3D models were used for dynamic 3D impingement-simulation. All patients underwent surgical treatment, eight patients underwent modified-Dunn-procedure.

Results
(1)MRI-based 3D segmentation was feasible in all patients(100%, duration of 4.5 hours, mean 277±52 minutes).
(2)3D-printing of the 3D-models was feasible in all patients(100%). 3D-models were considered helpful for preoperative planning by the treating surgeons. Dynamic 3D impingement-simulation was feasible in 6 patients(6 hips) and enabled visualization of femoral and acetabular impingement location.
(3)Hip range of motion was symmetrical and clinical outcome was good at short term followup. Slip angle improved significantly (p < 0.001) from preoperative 54±15° (40-70) to postoperative 3±5° (2-4).

Conclusion
MRI-based 3D-models for SCFE patients were feasible for all patients. 3D-models can be used for 3D-printing and for impingement-simulation. This could aid for patient-specific preoperative planning. MRI-based 3D-models are radiation-free and could be used instead of CT-based 3D-models in the future.