Sarmiento Riveros Paula Andrea, Jaramillo Quiceno Alejandro, Arias Pérez Rubén Darío, Velásquez López Mateo, Vega Arango Miguel, Mejía Henao Juan Camilo
Orthopedic and Traumatology Service Clinica del Campestre, Medellín, Colombia.
Orthopedic and Traumatology Service Salud Sura, Medellín, Colombia.
Arthrosc Tech. 2025 Apr 10;14(6):103542. doi: 10.1016/j.eats.2025.103542. eCollection 2025 Jun.
In complex cases of meniscus allograft transplantation, such as in double transplants, and when they are combined with ligament reconstructions, there is a high risk of tunnel overlap, which may compromise graft integrity and lead to treatment failure. Additionally, matching the meniscal allograft size to the patient's knee anatomy is critical and challenging. To address these challenges, a preoperative protocol was developed using three-dimensional (3D) printing. First, tomography of the knee is used to make a 3D model of the proximal tibia. This model is printed in real size and is used for allograft selection. The surgical team uses the model to determine the drilling parameters of the tunnels for the double meniscus allograft transplantation and anterior cruciate ligament reconstruction, ensuring that no overlap occurs. Finally, the 3D model serves as a guide during surgery for accurate tunnel and graft placement. The 3D model provides a versatile tool for planning meniscal transplants, especially in revision surgeries or complex cases, improving preoperative visualization and surgical precision. This technique can ensure optimal graft selection, facilitate precise replication of the drilling parameters, and enhance surgical outcomes.
在半月板同种异体移植的复杂病例中，例如双移植，以及当它们与韧带重建相结合时，存在隧道重叠的高风险，这可能会损害移植物的完整性并导致治疗失败。此外，使半月板同种异体移植物的大小与患者的膝关节解剖结构相匹配至关重要且具有挑战性。为应对这些挑战，制定了一种使用三维（3D）打印的术前方案。首先，利用膝关节断层扫描制作近端胫骨的3D模型。该模型按实际尺寸打印，并用于同种异体移植物的选择。手术团队使用该模型确定双半月板同种异体移植和前交叉韧带重建的隧道钻孔参数，确保不发生重叠。最后，3D模型在手术期间作为准确放置隧道和移植物的指导。3D模型为半月板移植规划提供了一种通用工具，特别是在翻修手术或复杂病例中，可改善术前可视化和手术精度。该技术可确保最佳的移植物选择，便于精确复制钻孔参数，并提高手术效果。
