Eberlein Sophie C, Hess Silvan, Schaible Samuel F, Klenke Frank M, Hecker Andreas
Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, Bern, 3010, Switzerland.
3D Print Med. 2025 Feb 19;11(1):6. doi: 10.1186/s41205-024-00215-0.
Anterior cruciate ligament reconstruction (ACLR) failures are associated with misplacement of the bone tunnels in up to 88%. The aim of this study is to evaluate the feasibility and accuracy of ACL tunnel placement performed with 3D printed guides.
3D models of the femur and tibia from ten porcine specimens were reconstructed using CT scans. ACL tunnel aiming guides were created and fitted to the proximal tibial and distal femoral metaphyseal cortices. Each guide comprised two sleeves to secure the guide to the bone using Kirschner wires and one sleeve for inserting the ACL tunnel guide wire. Guides were printed using a biomedically certified resin on the in-house 3D printer. They were fixed to the antero-medial tibia/distal-lateral femur with Kirschner wires and the ACL guide wire was inserted, then the guides were removed and the ACL guide wire was drilled over. Post-operative CT scans were obtained in order to compare the actual positions of the tunnel to the planned positions. Results are presented as medians and ranges since normal distribution could not be confirmed.
Median deviations between preoperative plan and actual postoperative positon were 1.15 mm (0.7-3 mm) and 0.75 mm (0.3-2.8 mm) for femoral and tibial tunnels, respectively.
Good accuracy of ACL tunnel placement can be achieved using 3D printed guides. Applied to a clinical setting, this technique has the potential to significantly reduce complications due to misplacement of bone tunnels.
前交叉韧带重建（ACLR）失败与高达88%的骨隧道放置不当有关。本研究的目的是评估使用3D打印导向器进行ACL隧道放置的可行性和准确性。
使用CT扫描重建10个猪标本的股骨和胫骨的3D模型。制作ACL隧道瞄准导向器并将其安装到近端胫骨和远端股骨干骺端皮质上。每个导向器包括两个用于使用克氏针将导向器固定到骨上的套筒和一个用于插入ACL隧道导丝的套筒。导向器使用经生物医学认证的树脂在内部3D打印机上打印。用克氏针将它们固定到胫骨前内侧/股骨远端外侧，插入ACL导丝，然后移除导向器并钻通ACL导丝。术后进行CT扫描以比较隧道的实际位置与计划位置。由于无法确认正态分布，结果以中位数和范围表示。
股骨和胫骨隧道术前计划与术后实际位置的中位数偏差分别为1.15毫米（0.7 - 3毫米）和0.75毫米（0.3 - 2.8毫米）。
使用3D打印导向器可实现良好的ACL隧道放置准确性。应用于临床，该技术有可能显著减少因骨隧道放置不当引起的并发症。
