Planning for success

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Planning for success

• The high value hip
• Justin Cobb
• Chair of Orthopaedics
• Imperial College London
• Vijay Kannan, Wael Dandachli, Hardik Patel, Peter
  Darcy

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Objectives of this talk

• 1 frames of reference
• acetabular and femoral orientation
• 2 use them to orientate in
• resurfacing arthroplasty
• Precise acetabular position
• Precise femoral position
• A matched couple
• 3 look at impact on learning

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Plan your compromises

• Resurfacing has a new level of compromise
• Best Bone interface
• On head, or neck?

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Resurfacing has compromises 2

• Minimise bone resection
• But plain films are inaccurate
• 44 looks too small, will notch neck
• 48 looks better, but was too big on table

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Resurfacing has compromises 3

• Cant alter
• Neck angle and neck anteversion
• Can alter
• neck length
• head on neck angulation and translation
• osteochondroplasty often needed

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Ct based system

• Freeware for training and planning
• www.acrobot.co.uk
• Low dose protocol
• Segmentation and orientation by radiographer

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What does it cost?

• Time
• 2 minutes of fun preop with your patient
• Time neutral in theatre
• Effort
• Organising the system in your hospital
• Money
• Ct, processing, navigation

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Precise resurfacing

• For the high value hip
• Navigation
• Should become standard of care
• Preop planning
• Will make it quicker and safer