{"id":740,"date":"2017-01-06T15:23:47","date_gmt":"2017-01-06T06:23:47","guid":{"rendered":"http:\/\/www.lexi.co.jp\/?page_id=740"},"modified":"2020-03-13T20:30:55","modified_gmt":"2020-03-13T11:30:55","slug":"shiraniwa-byouin","status":"publish","type":"page","link":"http:\/\/www.lexi.co.jp\/en\/installations\/shiraniwa-byouin","title":{"rendered":"Case Study: Shiraniwa Hospital"},"content":{"rendered":"<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2017\/01\/shiraniwa_en_header.png\" width=\"100%\" style=\"border: 1px solid #333\" class=\"alignnone size-full wp-image-327\"><br \/>\n            <div class=\"ui modal\">\r\n                <div class=\"header\">\r\n                    Notice\r\n                <\/div>\r\n                <div class=\"content\">\r\n                    <div class=\"description\">\r\n                        <p>\r\n                            The pages you are about to visit include information on a \"professional use only\" medical device.  It is not intended for general distribution.  Are you a medical professional?\r\n                        <\/p>\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"actions\">\r\n                    <div class=\"ui black deny button\">\r\n                        No\r\n                    <\/div>\r\n                    <div class=\"ui positive right labeled icon button\">\r\n                        Yes\r\n                        <i class=\"checkmark icon\"><\/i>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <script type=\"text\/javascript\">\r\n                jQuery(function ($) {\r\n                    var dlg = $('.ui.modal')\r\n                        .modal('setting', {\r\n                                closable: false,\r\n                                onApprove: function() {\r\n                                    $.cookie('medical_warn_checked', 'true', { expires: 30, path: '\/' });\r\n                                    return true;\r\n                                },\r\n                                onDeny: function() {\r\n                                    location.href=\"\/en\/\";\r\n                                    return true;\r\n                                }\r\n                            }\r\n                        );\r\n                    if($.cookie('medical_warn_checked') === undefined)\r\n                    {\r\n                        dlg.modal('show');\r\n                    }\r\n                });\r\n            <\/script><\/p>\n<h1>THA Pre-Operative Planning<\/h1>\n<p><imgsrc=\" v2012=\"\" images=\"\" installation=\"\" shiraniwa_jutuzen.jpg\"=\"\"><\/imgsrc=\"><\/p>\n<h3>X-ray film templating<\/h3>\n<table class=\"ui celled structured blue table\">\n<tbody>\n<tr>\n<td>Advantage(s)<\/td>\n<td>\n<ul>\n<li>Easy to use<\/li>\n<li>No extra cost<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Disadvantage(s)<\/td>\n<td>\n<ul>\n<li>Inaccurate magnification ratio<\/li>\n<li>Accuracy lower than 3D templating (Carter LW. J Arthro. 1995)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>2D digital templating<\/h3>\n<table class=\"ui celled structured blue table\">\n<tbody>\n<tr>\n<td>Advantage(s)<\/td>\n<td>\n<ul>\n<li>Easy to use<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Disadvantage(s)<\/td>\n<td>\n<ul>\n<li>Inaccurate magnification ratio, expensive, accuracy equivalent to the conventional method (Gamble P et al. J Arthro. 2010)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr><\/tr>\n<\/tbody>\n<\/table>\n<h3>Navigation system<\/h3>\n<table class=\"ui celled structured blue table\">\n<tbody>\n<tr>\n<td>Advantage(s)<\/td>\n<td>\n<ul>\n<li>High accuracy<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Disadvantage(s)<\/td>\n<td>\n<ul>\n<li>Extended operation time, cumbersome equipment, expensive (Stiehl JB. Comput Aided Surg. 2007)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr><\/tr>\n<\/tbody>\n<\/table>\n<h3>3D templating<\/h3>\n<table class=\"ui celled structured blue table\">\n<tbody>\n<tr>\n<td>Advantage(s)<\/td>\n<td>\n<ul>\n<li>High accuracy (Viceconti M et al. Med Inform Internet. 2002, Manaka et al. Hip Joint. 2006, Sariali E et al. JBJS-B. 2009)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h1>Purpose of this study<\/h1>\n<p>To examine effectiveness of ZedHip in THA pre-operative planning.<\/p>\n<h1>Subjects<\/h1>\n<h2>Period and the number of samples<\/h2>\n<p>32 patients with 34 hips (4 male and 28 female) for THA from July 2011 to August 2012.<\/p>\n<h2>Average age<\/h2>\n<p>72 years old (50-89 years old).<\/p>\n<h2>Used implants<\/h2>\n<ul>\n<li>Cup\uff1aTrident PSL (Stryker)<\/li>\n<li>Stem\uff1aProfemur Z (Wright Medical)<\/li>\n<\/ul>\n<h2>Primary diseases<\/h2>\n<ul>\n<li>Hip osteoarthritis: 30 hips<\/li>\n<li>Idiopathic femoral head necrosis: 3 hips<\/li>\n<li>Femoral neck fracture: 1 hip<\/li>\n<\/ul>\n<h2>Items to be examined<\/h2>\n<ul>\n<li>Match rate between planned and used implants<\/li>\n<li>Angles of post-operative implant position<\/li>\n<li>Post-operative complications<\/li>\n<\/ul>\n<h1>Results<\/h1>\n<h2>Cup<\/h2>\n<div class=\"alignright\" style=\"max-width: 75%; margin-left: 16px;\">\n<img decoding=\"async\" src=\"\/wp-content\/uploads\/2017\/01\/shiraniwa_en_1.png\" style=\"max-width:500px;\"><\/div>\n<div class=\"cf\" style=\"width:100%\">\n<h3>Match rate of implants<\/h3>\n<ul>\n<li>Perfect matching: 31 hips (91%)<\/li>\n<li>1 size up: 2 hips<\/li>\n<li>1 size down: 1 hip<\/li>\n<\/ul>\n<h3>Angles of implant position (in degrees)<\/h3>\n<ul>\n<li>Inclination: 43.8\u00b14.5<\/li>\n<li>Anteversion: 18.2\u00b16.7<\/li>\n<\/ul>\n<\/div>\n<h2>Stem<\/h2>\n<h3>Match rate of implants<\/h3>\n<ul>\n<li>Perfect matching: 20 hips (59%) (*1)<\/li>\n<li>1 size down: 14 hips (41%)<\/li>\n<\/ul>\n<h3>Angles of implant position (in degrees)<\/h3>\n<ul>\n<li>Varus: 2.1\u00b11.2 (range: 0\u20154.9)<\/li>\n<li>Flexion: 3.2\u00b12.0 (range: -0.7\u20157.1)<\/li>\n<li>Anteversion: 8.2\u00b15.9 (range: -16.5\u201519.1)<\/li>\n<\/ul>\n<div class=\"ui pointing label\" style=\"font-size: 100%\">\n*1: Reasons for the low match rate of the stem may include:<\/p>\n<p>&#8211; Rotation (dispersion of anteversion)<\/p>\n<p>&#8211; Bone resection distance error<\/p>\n<p>&#8211; Insert position error<\/p>\n<p>&#8211; Stem shape etc.<\/p>\n<\/div>\n<h2>Case 1<\/h2>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2017\/01\/shiraniwa_en_2.png\"><\/p>\n<h2>Case 2<\/h2>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2017\/01\/shiraniwa_en_3.png\"><\/p>\n<h2>Summary<\/h2>\n<table class=\"ui celled structured blue table\">\n<tbody>\n<tr class=\"topRow\">\n<td class=\"grid\"><\/td>\n<td class=\"grid\" colspan=\"2\">2D<\/td>\n<td class=\"grid\" colspan=\"2\">3D<\/td>\n<\/tr>\n<tr class=\"colum\">\n<td class=\"mostLeftCol grid\"><\/td>\n<td class=\"mostLeftCol grid\">Conventional<br \/>\nfrontal plain X-ray<\/td>\n<td class=\"mostLeftCol grid\">Digital Templating<\/td>\n<td class=\"mostLeftCol grid\">Navigation System<\/td>\n<td class=\"mostLeftCol grid\">Digital Templating<br \/>\n(ZedHip)<\/td>\n<\/tr>\n<tr class=\"colum\" style=\"text-align: center\">\n<td class=\"mostLeftCol grid\">Accuracy of implant positions<\/td>\n<td class=\"grid\">\u25b3<\/td>\n<td class=\"grid\">\u25b3<\/td>\n<td class=\"grid\">\u25ce<\/td>\n<td class=\"grid\">\u25cb (*1)<\/td>\n<\/tr>\n<tr class=\"colum\" style=\"text-align: center\">\n<td class=\"mostLeftCol grid\">Radiation exposure<\/td>\n<td class=\"grid\">\u25cb<\/td>\n<td class=\"grid\">\u25cb<\/td>\n<td class=\"grid\">\u25cb<\/td>\n<td class=\"grid\">\u25cb<\/td>\n<\/tr>\n<tr class=\"colum\" style=\"text-align: center\">\n<td class=\"mostLeftCol grid\">User-friendliness<\/td>\n<td class=\"grid\">\u25cb<\/td>\n<td class=\"grid\">\u25cb<\/td>\n<td class=\"grid\">\u25b3<\/td>\n<td class=\"grid\">\u25cb (*2)<\/td>\n<\/tr>\n<tr class=\"colum\" style=\"text-align: center\">\n<td class=\"mostLeftCol grid\">Cost<\/td>\n<td class=\"grid\">\u25ce<\/td>\n<td class=\"grid\">\u25b3<\/td>\n<td class=\"grid\">\u00d7<\/td>\n<td class=\"grid\">\u25cb<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>*1: Accuracy higher than 2D and almost equivalent to the navigation system<br \/>\n*2: About 15 minutes for pre-operative planning and simulation<\/p>\n<h1>Advantages of ZedHip<\/h1>\n<ul>\n<li>ROM simulation (dislocation test)<\/li>\n<li>Simulations of osteophyte resection and pelvic reference plane change<\/li>\n<li>Easy for inexperienced surgeons to imagine the actual surgery<\/li>\n<\/ul>\n<p><strong>* What is most important here is how accurately ZedHip helps realize its pre-operative planning in the actual surgical field.<\/strong><\/p>\n<h1>Conclusions<\/h1>\n<ul>\n<li>The match rates of implants were 91% for the cup and 59% for the stem.<\/li>\n<li>ZedHip pre-operatively allows us to identify osteophytes and bone cysts in 3D, hence to understand their sizes and locations more accurately than other methods.<\/li>\n<li>Pre-operative planning by ZedHip would be a useful tool for preparing for surgery with confidence.<\/li>\n<li>There still remains the difficulty of placing implants as planned.<\/li>\n<li>It would be a more practical method for general hospitals in planning surgery pre-operatively.<\/li>\n<\/ul>\n<div class=\"installation_access\">\n<p style=\"font-weight: bolder\">Joint Arthroplasty Center, Shiraniwa Hospital<\/p>\n<p>6-10-1 Shiraniwadai, Ikoma, Nara, 630-0136 Japan<\/p>\n<p><a href=\"http:\/\/www.allpines.jp\/index.html\" target=\"_blank\" style=\"text-decoration: underline\" rel=\"noopener noreferrer\">http:\/\/www.allpines.jp\/index.html<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>THA Pre-Operative Planning<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":738,"menu_order":8,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_locale":"en_US","_original_post":"326","footnotes":""},"class_list":{"0":"post-740","1":"page","2":"type-page","3":"status-publish","5":"en-US","6":"czr-hentry"},"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/pages\/740","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/comments?post=740"}],"version-history":[{"count":17,"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/pages\/740\/revisions"}],"predecessor-version":[{"id":1622,"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/pages\/740\/revisions\/1622"}],"up":[{"embeddable":true,"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/pages\/738"}],"wp:attachment":[{"href":"http:\/\/www.lexi.co.jp\/wp-json\/wp\/v2\/media?parent=740"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}