Bergemann Reza, Roytman Gregory R, Ani Lidia, Ramji Alim F, Leslie Michael P, Tommasini Steven M, Wiznia Daniel H
Orthopaedics and Rehabilitation, Yale School of Medicine, Yale University, 333 Cedar St. FMB 5, New Haven, CT, 06511, USA.
Biomedical Engineering, Yale School of Engineering and Applied Sciences, Yale University, New Haven, USA.
3D Print Med. 2024 Mar 1;10(1):7. doi: 10.1186/s41205-024-00204-3.
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.
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.
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.
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.
转子延长截骨术（ETO）是一种用于暴露股骨近端髓腔、保护软组织并促进可靠愈合的外科技术。然而，截骨术执行不精确可能导致骨折、软组织损伤、骨不连和不必要的发病率。我们开发了一种技术，以创建患者特异性的3D打印切割导板，以帮助准确进行ETO定位，并提高截骨质量和手术效果。
使用Synopysis Simpleware ScanIP和Solidworks基于CT扫描创建患者特异性切割导板。定制的3D打印切割导板在带有泡沫皮质外壳的合成股骨和尸体股骨上进行测试。为了确认截骨术的准确性，将实际进行的截骨术尺寸与虚拟计划的截骨术尺寸进行比较。
使用患者特异性ETO切割导板成功进行了截骨术，在合成锯骨模型和尸体测试中均暴露了股骨髓腔和股骨柄。在尸体测试中，导板允许进行无骨折的截骨术，并且使用导板进行的切割与虚拟计划的截骨术相比误差在6%以内。
用于辅助ETO的3D打印患者特异性切割导板被证明是准确的。通过切割导板的迭代开发，我们发现简单的设计是可靠和准确导板的关键。虽然未来需要在人体受试者中进行临床试验，但我们相信我们定制的3D打印切割导板设计在辅助进行翻修全髋关节置换手术的ETO方面是有效的。
