Clinical Research Directory

3D-Printed Pelvic Models for Planning Complex Total Hip Arthroplasty

Total hip arthroplasty (THA) in patients with complex acetabular anatomy can be challenging because of abnormal bone structure, deformity, or bone loss. Accurate preoperative planning is important for selecting the appropriate acetabular component, determining its position, and achieving stable fixation. This prospective study aims to evaluate whether patient-specific, CT-based three-dimensional (3D)-printed pelvic models improve preoperative planning in complex total hip arthroplasty compared with conventional radiographic and CT-based planning. Patients undergoing complex primary or revision THA at Ain Shams University Hospitals will be included. For each patient, two preoperative plans will be prepared. Plan A will use conventional radiographs and CT images, while Plan B will additionally use a life-size 3D-printed pelvic model for surgical planning and simulation. Both plans will be compared with the actual acetabular component size and orientation achieved during surgery. The study will also evaluate changes in surgical planning, restoration of the hip center, operative parameters, postoperative complications, functional outcomes, and the practical feasibility of 3D printing. Patients will undergo postoperative follow-up for six months. The study seeks to determine the additional value of 3D-printed pelvic models in improving planning accuracy and supporting surgical decision-making in complex hip replacement.

Pelvic and Acetabular Fracture: A Prospective Observational Study

The purpose of this study is to understand the trajectory of function and self-reported outcomes of patients following pelvic and acetabular, treated both operatively and nonoperatively.

Corona Mortis in Patients Undergoing TEP for Inguinal Hernia

This study aim to describe the presence, type and size of Corona mortis (CMOR) in patients undergoing total extraperitoneal (TEP) inguinal hernia repair procedures. This study also aim to describe the preperitoneal vascular anatomy of inguinal area and provide in vivo knowledge about CMOR.

Geriatric Acetabular fracTures: Open Reduction Internal Fixation Versus Replacement

Management of acetabular (hip) fractures in the geriatric population can be very challenging because of pre-existing medical comorbidities, pre-existing osteoporosis and increased risk of mortality. The two most common treatment options for acetabular fractures are either surgical fixation using plates and screws to hold the fractured pieces in the correct position until the fracture has healed or surgical fixation in addition to a total hip replacement. Surgical fixation requires prolonged immobilization of the affected limb (typically around 6-12 weeks post-operatively), which can lead to disability and other complications. Such patients, especially those who are frail and cognitively impaired, are unable to adhere to the immobilization restrictions, leading to an increased risk of fixation failure. Patients who underwent open reduction internal fixation (ORIF) of an acetabular fracture were reported to have about 25 times greater incidence of hip replacement compared with general population matched controls. Additionally, performing a subsequent hip replacement after a previous surgical fixation (ORIF) of an acetabular fracture, especially in the elderly population, can present a number of technical difficulties including; difficult dissection due to previous incision(s) and scarring, dealing with retained hardware, bony deficiency and the possibility of infected hardware. The aim of the study is to perform a large cohort study to assess pain and physical function in patients 60 years and older who have sustained an acetabular fracture.

Pediatric Acetabular Fracture Registry

The investigators primary objective is to determine the fracture patterns, displacement-based treatment decisions, immediate and long-term complications, clinical, radiographic and patient reported outcomes of acetabular fractures with open physes. Hypothesis: This study will demonstrate that more complex and displaced fracture patterns are associated with a greater incidence of complications and poorer outcomes. The investigators secondary objective is to create a pediatric acetabular registry that can be used to track fracture patterns, displacement-based treatment decisions, immediate and long-term complications, clinical, radiographic and patient reported outcomes of acetabular fractures with open physes. Hypothesis: This study will demonstrate that more complex and displaced fracture patterns are associated with a greater incidence of complications and poorer outcomes.

Rim Plate to Buttress Plate for Posterior Wall Acetabular Fractures With and Without Inter-fragmentary Screws

The hypothesis of this study is that the Rim Plate method utilizing interfragmentary screws placed through the plate will result in superior fixation, a lower rate of loss of reduction of the fracture fragment, better anatomic healing of the articular (joint) surface, a decreased rate of early post-traumatic arthritic changes of the joint (cartilage) surface, and improved functional outcomes.

Weight-bearing of Surgically Treated Acetabular Fractures.

The purpose of this study is to determine whether patients with operatively treated acetabular fractures benefit from early weight-bearing as tolerated. The study compares two groups ( n = 25 each), which are randomised into either weight-bearing as tolerated or touch-down weight-bearing for 6-8 weeks postoperatively. Both study groups are stratified according to * Type of fracture (anterior approach vs anterior + additional posterior approach) * Dislocated dome vs non-dislocated/ non existing separate dome fragment Patients, who are eligible to participate in the trial but choose not to participate in randomisation are asked to enrol in a prospective cohort follow-up cohort. This is to examine a potential participation bias in the RCT groups. These patients will not be counted into the target amount of 50 RCT patients.