Mixed Reality Combined with Three-Dimensional Printing Technology in Total Hip Arthroplasty: An Updated Review with a Preliminary Case Presentation.

Three-dimensional (3D) printing technology, virtual reality, and augmented reality technology have been used to help surgeons to complete complex total hip arthroplasty, while their respective shortcomings limit their further application. With the development of technology, mixed reality (MR) technology has been applied to improve the success rate of complicated hip arthroplasty because of its unique advantages. We presented a case of a 59-year-old man with an intertrochanteric fracture in the left femur, who had received a prior left hip fusion. After admission to our hospital, a left total hip arthroplasty was performed on the patient using a combination of MR technology and 3D printing technology. Before surgery, 3D reconstruction of a certain bony landmark exposed in the surgical area was first performed. Then a veneer part was designed according to the bony landmark and connected to a reference registration landmark outside the body through a connecting rod. After that, the series of parts were made into a holistic reference registration instrument using 3D printing technology, and the patient's data for bone and surrounding tissue, along with digital 3D information of the reference registration instrument, were imported into the head-mounted display (HMD). During the operation, the disinfected reference registration instrument was installed on the selected bony landmark, and then the automatic real-time registration was realized by HMD through recognizing the registration landmark on the reference registration instrument, whereby the patient's virtual bone and other anatomical structures were quickly and accurately superimposed on the real body of the patient. To the best of our knowledge, this is the first report to use MR combined with 3D printing technology in total hip arthroplasty.

[Effect of comprehensive care for chronic filariasis patients with lymphedema].

OBJECTIVE: To evaluate the effect of chronic filariasis patients with lymphedema after comprehensive cared. METHODS: A total of 386 chronic filariasis patients with lymphedema received the comprehensive care including soaking feet by TCM, washing feet by single Chinese medicine or clear water, preventing and eliminating invasive wound, physical training, raising the limb, and wearing suitable shoes. The attack frequency of inflammation of lymphatic vessels, the stage of lymphedema disease, and leg circumference were observed before and after the care. RESULTS: After the comprehensive care, the attack rates of inflammation of lymphatic vessels decreased from 9.65% to 4.67%, and there was a significant difference (χ2 =7.34, P=0.0067). The proportion of the patients with high stage of lymphedema disease decreased significantly (all P <0.01), and the average leg circumference decreased of 1.06 cm. The skin appearance improved significantly. Other signs, such as pitting edema, ulcer, and skin folds also improved significantly (all P <0.01). CONCLUSION: The comprehensive care for chronic filariasis patients with lymphedema has a remarkable effect and is worthy of further application.