The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies
Abstract Background The extended trochanteric osteotomy (ETO) is a surgical technique utilized to expose the intramedullary canal of the proximal femur, protect the soft tissues and promote reliable healing. However, imprecise execution of the osteotomy can lead to fracture, soft tissue injury, non-...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | 3D Printing in Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41205-024-00204-3 |
| _version_ | 1797275866416283648 |
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| author | Reza Bergemann Gregory R. Roytman Lidia Ani Alim F. Ramji Michael P. Leslie Steven M. Tommasini Daniel H. Wiznia |
| author_facet | Reza Bergemann Gregory R. Roytman Lidia Ani Alim F. Ramji Michael P. Leslie Steven M. Tommasini Daniel H. Wiznia |
| author_sort | Reza Bergemann |
| collection | DOAJ |
| description | Abstract Background The extended trochanteric osteotomy (ETO) is a surgical technique utilized to expose the intramedullary canal of the proximal femur, protect the soft tissues and promote reliable healing. However, imprecise execution of the osteotomy can lead to fracture, soft tissue injury, non-union, and unnecessary morbidity. We developed a technique to create patient specific, 3D-printed cutting guides to aid in accurate positioning of the ETO and improve osteotomy quality and outcomes. Methods Patient specific cutting guides were created based on CT scans using Synopysis Simpleware ScanIP and Solidworks. Custom 3D printed cutting guides were tested on synthetic femurs with foam cortical shells and on cadaveric femurs. To confirm accuracy of the osteotomies, dimensions of the performed osteotomies were compared to the virtually planned osteotomies. Results Use of the patient specific ETO cutting guides resulted in successful osteotomies, exposing the femoral canal and the femoral stem both in synthetic sawbone and cadaveric testing. In cadaveric testing, the guides allowed for osteotomies without fracture and cuts made using the guide were accurate within 6 percent error from the virtually planned osteotomy. Conclusion The 3D-printed patient specific cutting guides used to aid in ETOs proved to be accurate. Through the iterative development of cutting guides, we found that a simple design was key to a reliable and accurate guide. While future clinical trials in human subjects are needed, we believe our custom 3D printed cutting guide design to be effective at aiding in performing ETOs for revision total hip arthroplasty surgeries. |
| first_indexed | 2024-03-07T15:20:11Z |
| format | Article |
| id | doaj.art-a4dd25b7ee2d47f3a23ecc6775029c40 |
| institution | Directory Open Access Journal |
| issn | 2365-6271 |
| language | English |
| last_indexed | 2024-03-07T15:20:11Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | 3D Printing in Medicine |
| spelling | doaj.art-a4dd25b7ee2d47f3a23ecc6775029c402024-03-05T17:44:06ZengBMC3D Printing in Medicine2365-62712024-03-011011810.1186/s41205-024-00204-3The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomiesReza Bergemann0Gregory R. Roytman1Lidia Ani2Alim F. Ramji3Michael P. Leslie4Steven M. Tommasini5Daniel H. Wiznia6Orthopaedics and Rehabilitation, Yale School of Medicine, Yale UniversityOrthopaedics and Rehabilitation, Yale School of Medicine, Yale UniversityOrthopaedics and Rehabilitation, Yale School of Medicine, Yale UniversityOrthopaedics and Rehabilitation, Yale School of Medicine, Yale UniversityOrthopaedics and Rehabilitation, Yale School of Medicine, Yale UniversityOrthopaedics and Rehabilitation, Yale School of Medicine, Yale UniversityOrthopaedics and Rehabilitation, Yale School of Medicine, Yale UniversityAbstract Background The extended trochanteric osteotomy (ETO) is a surgical technique utilized to expose the intramedullary canal of the proximal femur, protect the soft tissues and promote reliable healing. However, imprecise execution of the osteotomy can lead to fracture, soft tissue injury, non-union, and unnecessary morbidity. We developed a technique to create patient specific, 3D-printed cutting guides to aid in accurate positioning of the ETO and improve osteotomy quality and outcomes. Methods Patient specific cutting guides were created based on CT scans using Synopysis Simpleware ScanIP and Solidworks. Custom 3D printed cutting guides were tested on synthetic femurs with foam cortical shells and on cadaveric femurs. To confirm accuracy of the osteotomies, dimensions of the performed osteotomies were compared to the virtually planned osteotomies. Results Use of the patient specific ETO cutting guides resulted in successful osteotomies, exposing the femoral canal and the femoral stem both in synthetic sawbone and cadaveric testing. In cadaveric testing, the guides allowed for osteotomies without fracture and cuts made using the guide were accurate within 6 percent error from the virtually planned osteotomy. Conclusion The 3D-printed patient specific cutting guides used to aid in ETOs proved to be accurate. Through the iterative development of cutting guides, we found that a simple design was key to a reliable and accurate guide. While future clinical trials in human subjects are needed, we believe our custom 3D printed cutting guide design to be effective at aiding in performing ETOs for revision total hip arthroplasty surgeries.https://doi.org/10.1186/s41205-024-00204-33D PrintingCutting guideTotal hip arthroplastyExtended trochanteric osteotomyPatient specific instrumentation |
| spellingShingle | Reza Bergemann Gregory R. Roytman Lidia Ani Alim F. Ramji Michael P. Leslie Steven M. Tommasini Daniel H. Wiznia The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies 3D Printing in Medicine 3D Printing Cutting guide Total hip arthroplasty Extended trochanteric osteotomy Patient specific instrumentation |
| title | The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies |
| title_full | The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies |
| title_fullStr | The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies |
| title_full_unstemmed | The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies |
| title_short | The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies |
| title_sort | feasibility of a novel 3d printed patient specific cutting guide for extended trochanteric osteotomies |
| topic | 3D Printing Cutting guide Total hip arthroplasty Extended trochanteric osteotomy Patient specific instrumentation |
| url | https://doi.org/10.1186/s41205-024-00204-3 |
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