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Online ISSN 1827-1707
Viceconti M. 1, Testi D. 1, Toni A. 1,2
1 Laboratory of Medical Technology Istituti Ortopedici Rizzoli, Bologna, Italy
2 1st Division of Orthopaedic Surgery Istituti Ortopedici Rizzoli, Bologna, Italy
Although the failure rate of total hip replacement is minimal, the high number of operation performed every year makes the absolute number of revision still quite high. One of the possible solutions to further improve the outcome of total hip replacements, may come from those assistive technologies and, in particular, from computer-aided pre-operative planning. A state-of-the-art on computer-aided pre-operative planning is presented considering both digital templating and CT-based planning. From this review it results that digital templating can only alleviate the important limitations of radiographic planning, namely the semi-quantitative nature of the procedure, and the total lack of control over the internal-external orientation of the prosthetic components. All these problems are effectively solved only using CT-based planning and concerns expressed by some users on the use of CT data for pre-operative planning appear to be unsupported. On the contrary, the use of CT-based pre-operative planning produces measurable improvements over radiographic methods. Surgeons can be further helped by advanced systems for the pre-operative planning to decide which is the best position to be achieved with the prosthetic components. In this context, 2 possible future scenarios are presented related to the inclusion in the pre-operative planning of functional outcomes, and virtual reality technologies.