新型三维打印病人专用切割导板用于延长转子截骨术的可行性。

IF 3.2 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Reza Bergemann, Gregory R Roytman, Lidia Ani, Alim F Ramji, Michael P Leslie, Steven M Tommasini, Daniel H Wiznia
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引用次数: 0

摘要

背景:股骨转子延长截骨术(ETO)是一种用于暴露股骨近端髓内管、保护软组织并促进可靠愈合的手术技术。然而,不精确的截骨术可能导致骨折、软组织损伤、不愈合和不必要的发病率。我们开发了一种技术来制作患者专用的 3D 打印切割导板,以帮助准确定位 ETO 并提高截骨质量和效果:方法:使用 Synopysis Simpleware ScanIP 和 Solidworks 根据 CT 扫描创建患者专用切割导板。在带有泡沫皮质外壳的合成股骨和尸体股骨上测试了定制的 3D 打印切割导板。为确认截骨的准确性,将已实施截骨的尺寸与虚拟计划截骨的尺寸进行了比较:结果:在合成锯骨和尸体测试中,使用患者专用的ETO切割导板都能成功截骨,露出股骨管和股骨柄。在尸体测试中,导板可在不发生骨折的情况下进行截骨,使用导板进行的切割与实际计划的截骨误差在6%以内:事实证明,用于辅助 ETO 的病人专用 3D 打印切割导板是准确的。通过迭代开发切割导板,我们发现简单的设计是获得可靠、精确导板的关键。虽然未来还需要在人体中进行临床试验,但我们相信我们定制的 3D 打印切割导板设计能够有效地帮助翻修全髋关节置换手术中的 ETO 操作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The feasibility of a novel 3D-Printed patient specific cutting guide for extended trochanteric osteotomies.

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.

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