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The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study

OBJECTIVE: High tibial osteotomy (HTO) has been used for the treatment of patients with knee osteoarthritis. However, the successful implementation of HTO requires precise intraoperative positioning, which places greater requirements on the surgeon. In this study, we aimed to design a new kind of 3D...

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Autores principales: Miao, Zhuang, Li, Songlin, Luo, Desu, Lu, Qunshan, Liu, Peilai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800288/
https://www.ncbi.nlm.nih.gov/pubmed/35093132
http://dx.doi.org/10.1186/s13018-022-02956-2
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author Miao, Zhuang
Li, Songlin
Luo, Desu
Lu, Qunshan
Liu, Peilai
author_facet Miao, Zhuang
Li, Songlin
Luo, Desu
Lu, Qunshan
Liu, Peilai
author_sort Miao, Zhuang
collection PubMed
description OBJECTIVE: High tibial osteotomy (HTO) has been used for the treatment of patients with knee osteoarthritis. However, the successful implementation of HTO requires precise intraoperative positioning, which places greater requirements on the surgeon. In this study, we aimed to design a new kind of 3D-printed patient-specific instrument (PSI) for HTO, including a positioning device and an angle bracing spacer, and verify its effectiveness using cadaveric specimens. METHODS: This study included ten fresh human lower-limb cadaveric specimens. Computed tomography (CT) and X-ray examinations were performed to make preoperative plans. PSI was designed and 3D-printed according to the preoperative plan. Then, the PSI was used to guide HTO. Finally, we performed X-ray and CT after the operation to verify its validity and accuracy. RESULTS: The PSI using process was adjusted according to the pre-experimental procedure in 1 case. Hinge fracture occurred in 1 case. According to X-rays of the remaining eight cadaveric specimens, no statistically significant difference was noted between the preoperative planning medial proximal tibial angle (MPTA) and postoperative MPTA (P > 0.05) or the preoperative and postoperative posterior slope angle (PSA) (P > 0.05). According to the CT of 10 cadaveric specimens, no statistically significant difference was noted between the design angle and actual angle, which was measured according to the angle between the osteotomized line and the cross section (P > 0.05). The gap between the designed osteotomy line and the actual osteotomy line was 2.09 (0.8 ~ 3.44) mm in the coronal plane and 1.58 (0.7 ~ 2.85) mm in the sagittal plane. CONCLUSION: This 3D-printed PSI of HTO accurately achieves the angle and position of the preoperative plan without increasing the stripping area. However, its use still requires a certain degree of proficiency to avoid complications, such as hinge fracture.
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spelling pubmed-88002882022-02-02 The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study Miao, Zhuang Li, Songlin Luo, Desu Lu, Qunshan Liu, Peilai J Orthop Surg Res Research Article OBJECTIVE: High tibial osteotomy (HTO) has been used for the treatment of patients with knee osteoarthritis. However, the successful implementation of HTO requires precise intraoperative positioning, which places greater requirements on the surgeon. In this study, we aimed to design a new kind of 3D-printed patient-specific instrument (PSI) for HTO, including a positioning device and an angle bracing spacer, and verify its effectiveness using cadaveric specimens. METHODS: This study included ten fresh human lower-limb cadaveric specimens. Computed tomography (CT) and X-ray examinations were performed to make preoperative plans. PSI was designed and 3D-printed according to the preoperative plan. Then, the PSI was used to guide HTO. Finally, we performed X-ray and CT after the operation to verify its validity and accuracy. RESULTS: The PSI using process was adjusted according to the pre-experimental procedure in 1 case. Hinge fracture occurred in 1 case. According to X-rays of the remaining eight cadaveric specimens, no statistically significant difference was noted between the preoperative planning medial proximal tibial angle (MPTA) and postoperative MPTA (P > 0.05) or the preoperative and postoperative posterior slope angle (PSA) (P > 0.05). According to the CT of 10 cadaveric specimens, no statistically significant difference was noted between the design angle and actual angle, which was measured according to the angle between the osteotomized line and the cross section (P > 0.05). The gap between the designed osteotomy line and the actual osteotomy line was 2.09 (0.8 ~ 3.44) mm in the coronal plane and 1.58 (0.7 ~ 2.85) mm in the sagittal plane. CONCLUSION: This 3D-printed PSI of HTO accurately achieves the angle and position of the preoperative plan without increasing the stripping area. However, its use still requires a certain degree of proficiency to avoid complications, such as hinge fracture. BioMed Central 2022-01-29 /pmc/articles/PMC8800288/ /pubmed/35093132 http://dx.doi.org/10.1186/s13018-022-02956-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Miao, Zhuang
Li, Songlin
Luo, Desu
Lu, Qunshan
Liu, Peilai
The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study
title The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study
title_full The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study
title_fullStr The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study
title_full_unstemmed The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study
title_short The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study
title_sort validity and accuracy of 3d-printed patient-specific instruments for high tibial osteotomy: a cadaveric study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800288/
https://www.ncbi.nlm.nih.gov/pubmed/35093132
http://dx.doi.org/10.1186/s13018-022-02956-2
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