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Planning for success

Planning for success. The high value hip Justin Cobb Chair of Orthopaedics Imperial College London Vijay Kannan, Wael Dandachli, Hardik Patel, Peter Darcy. Objectives of this talk. 1 frames of reference acetabular and femoral orientation 2 use them to orientate in

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Planning for success

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  1. Planning for success The high value hip Justin Cobb Chair of Orthopaedics Imperial College London Vijay Kannan, Wael Dandachli, Hardik Patel, Peter Darcy

  2. 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

  3. Plan your compromises • Resurfacing has a new level of compromise • Best Bone interface • On head, or neck?

  4. 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

  5. Resurfacing has compromises 3 • Can’t alter: • Neck angle and neck anteversion • Can alter: • neck length • head on neck angulation and translation • osteochondroplasty often needed

  6. Freeware for training and planning www.acrobot.co.uk Low dose protocol Segmentation and orientation by radiographer Ct based system

  7. 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:

  8. Precise resurfacing • For the high value hip • Navigation • Should become ‘standard of care’ • Preop planning • Will make it quicker and safer

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