Molecular Biology and Genetics Department, Science and Literature Faculty, Istanbul Technical University, Maslak, 34469, Istanbul, Turkey.
Faculty of Manufacturing Engineering, Istanbul Technical University, Gumussuyu, 34437, Istanbul, Turkey.
Sci Rep. 2023 Feb 24;13(1):3204. doi: 10.1038/s41598-023-30341-4.
Patellar luxation with condylar defect is a challenging situation for reconstruction in humans. Patella reluxation, cartilage damage and pain are the most common complications. This study aims to present a new patient specific method of overformed implant design and clinical implantation that prevents luxation of patella without damaging the cartilage in a dog. Design processes are Computer Tomography, Computer Assisted Design, rapid prototyping of the bone replica, creation of the implant with surgeon's haptic knowledge on the bone replica, 3D printing of the implant and clinical application. The implant was fully seated on the bone. Patella reluxation or implant-related bone problem was not observed 80 days after the operation. However, before the implant application, there were soft tissue problems due to previous surgeries. Three-point bending test and finite element analysis were performed to determine the biomechanical safety of the implant. The stress acting on the implant was below the biomechanical limits of the implant. More cases with long-term follow-up are needed to confirm the success of this method in patellar luxation. Compared with trochlear sulcoplasty and total knee replacement, there was no cartilage damage done by surgeons with this method, and the implant keeps the patella functionally in sulcus. This is a promising multidisciplinary method that can be applied to any part of the bone and can solve some orthopaedic problems with surgeon's haptic knowledge.
髌骨脱位伴滑车发育不良是人类重建的一个具有挑战性的情况。髌骨再脱位、软骨损伤和疼痛是最常见的并发症。本研究旨在介绍一种新的患者特异性方法，即过度成形植入物设计和临床植入，以防止犬髌骨脱位而不损伤软骨。设计过程包括计算机断层扫描、计算机辅助设计、骨复制的快速原型制作、在骨复制上具有外科医生触觉知识的植入物的创建、植入物的 3D 打印和临床应用。植入物完全置于骨上。术后 80 天未观察到髌骨再脱位或与植入物相关的骨问题。然而，在植入物应用之前，由于先前的手术存在软组织问题。进行了三点弯曲试验和有限元分析，以确定植入物的生物力学安全性。作用在植入物上的应力低于植入物的生物力学极限。需要更多的长期随访病例来确认这种髌骨脱位治疗方法的成功。与滑车成形术和全膝关节置换术相比，该方法不会对软骨造成损伤，且植入物使髌骨在滑车沟内保持功能。这是一种有前途的多学科方法，可以应用于骨骼的任何部位，并可以利用外科医生的触觉知识解决一些骨科问题。
