Three-Dimensional Correction of Complex Ankle Deformities With Computer-Assisted Planning and Patient-Specific Surgical Guides

2017 ◽  
Vol 56 (6) ◽  
pp. 1158-1164 ◽  
Author(s):  
Lizzy Weigelt ◽  
Philipp Fürnstahl ◽  
Stefanie Hirsiger ◽  
Lazaros Vlachopoulos ◽  
Norman Espinosa ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides

scholarly journals Corrective Osteotomy of Upper Extremity Malunions Using Three-Dimensional Planning and Patient-Specific Surgical Guides: Recent Advances and Perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Babak Saravi ◽  
Gernot Lang ◽  
Rebecca Steger ◽  
Andreas Vollmer ◽  
Jörn Zwingmann
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Therapeutic Approach ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Current Evidence ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides ◽  
Recent Advances

Malunions of the upper extremity can result in severe functional problems and increase the risk of osteoarthritis. The surgical reconstruction of complex malunions can be technically challenging. Recent advances in computer-assisted orthopedic surgery provide an innovative solution for complex three-dimensional (3-D) reconstructions. This study aims to evaluate the clinical applicability of 3-D computer-assisted planning and surgery for upper extremity malunions. Hence, we provide a summary of evidence on this topic and highlight recent advances in this field. Further, we provide a practical implementation of this therapeutic approach based on three cases of malunited forearm fractures treated with corrective osteotomy using preoperative three-dimensional simulation and patient-specific surgical guides. All three cases, one female (56 years old) and two males (18 and 26 years old), had painful restrictions in range of motion (ROM) due to forearm malunions and took part in clinical and radiologic assessments. Postoperative evaluation of patient outcomes showed a substantial increase in range of motion, reduction of preoperatively reported pain, and an overall improvement of patients' satisfaction. The therapeutic approach used in these cases resulted in an excellent anatomical and functional reconstruction and was assessed as precise, safe, and reliable. Based on current evidence and our results, the 3-D preoperative planning technique could be the new gold standard in the treatment of complex upper extremity malunions in the future.

Preoperative three-dimensional computer planning for reverse total shoulder arthroplasty and bone grafting for severe glenoid deformity

2020 ◽  
pp. 175857322090890
Author(s):  
Robert Z Tashjian ◽  
Lindsay Beck ◽  
Irene Stertz ◽  
Peter N Chalmers
Keyword(s):  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation ◽  
Reverse Total Shoulder ◽  
Glenoid Erosion

Background Computer assisted planning without patient specific instrumentation may be utilized to guide reverse total shoulder arthroplasty baseplate placement. The purpose of this study was to determine the difference between planned and achieved inclination and retroversion correction with three-dimensional preoperative computer assisted planning in reverse total shoulder arthroplasty without patient specific instrumentation with bone grafting for severe glenoid erosion. Methods Preoperative three-dimensional computer assisted planning without patient specific instrumentation was performed on 15 patients undergoing primary reverse total shoulder arthroplasty with glenoid bone grafting for severe glenoid erosion. On preoperative and immediate postoperative computed tomography slices, two-dimensional retroversion and inclination were measured. Preoperative three-dimensional baseline retroversion and inclination and planned postoperative three-dimensional retroversion and inclination were measured. Planned and achieved version and inclination changes were compared. Results The planned and achieved retroversion corrections were 18° and 12°, respectively (p < 0.001). The planned and achieved inclination corrections were 11° and 11°, respectively (p = 0.803). Conclusions Three-dimensional computer assisted planning without patient specific instrumentation in the setting of reverse total shoulder arthroplasty with severe glenoid erosion requiring bone grafting can accurately guide baseplate placement. All cases in which failure to correct retroversion or inclination within 10° of planning occurred in patients with severe erosion (B3 or E3 glenoids), therefore patient specific guides may be warranted in these cases to improve accuracy of implantation. Level of evidence Level IV, retrospective case series.

scholarly journals Computer-Assisted Planning and Three-Dimensional-Printed Patient-Specific Instrumental Guide for Corrective Osteotomy in Post-Traumatic Femur Deformity: A Case Report and Literature Review

2018 ◽  
Vol 24 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Lau Chi-Kay ◽  
Chui King-him ◽  
Lee Kin-bong ◽  
Li Wilson
Keyword(s):  
Lower Limb ◽  
New Technologies ◽  
Preoperative Planning ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Limb Deformity ◽  
Satisfactory Outcome ◽  
Post Traumatic

Post-traumatic limb deformity is often multiplanar and thus is a difficult pathology to deal with surgically. Precise preoperative planning and accurate intraoperative execution are two main important steps that lead to satisfactory outcome. Computer-assisted planning and three-dimensional-printed patient-specific instrumental guides provide excellent aid to the two steps, respectively. We report a case of posttraumatic lower limb deformity in a patient who underwent closing wedge corrective osteotomy with the aid of the aforementioned new technologies.

Computer-assisted extra-articular distal radius osteotomies using patient-specific surgical guides

10.29007/svbd ◽  
2018 ◽  
Author(s):  
Vasilii Shishkin ◽  
Valeriy Golubev
Keyword(s):  
Distal Radius ◽  
Patient Specific ◽  
Control Group ◽  
Computer Assisted ◽  
X Ray ◽  
Surgical Guides ◽  
Planning Approach ◽  
3D Printed ◽  
Planning Group

Malunions of the distal radius are often treated with correction osteotomies, which can be challenging to perform.In this report, 23 patients with symptomatic distal radius malunions were treated using 3D printed patient-specific surgical guides to facilitate surgery. Patients were compared with a control group of 23 patients that underwent similar surgery with a conventional x-ray planning approach.Postoperatively all patients in the computer-assisted group showed recovery of ROM, with no anatomical abnormalities on x-ray examination. 6 patients in the conventional planning group had reduced ROM with a residual volar tilt on x-ray images.Computer-assisted planning with the use of 3D printed patient-specific surgical guides enhances results of corrective osteotomies of distal radius malunions.

scholarly journals Comparison of Changes in the Condylar Volume and Morphology in Skeletal Class III Deformities Undergoing Orthognathic Surgery Using a Customized versus Conventional Miniplate: A Retrospective Analysis

2020 ◽  
Vol 9 (9) ◽  
pp. 2794
Author(s):  
You Na Lim ◽  
In-Young Park ◽  
Jong-Cheol Kim ◽  
Soo-Hwan Byun ◽  
Byoung-Eun Yang
Keyword(s):  
Conventional Method ◽  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Class Iii ◽  
Specific System ◽  
Sagittal Split Ramus Osteotomy ◽  
Skeletal Class ◽  
Surgical Technology ◽  
Significant Difference

With the great leap in the development of three-dimensional computer-assisted surgical technology, surgeons can use a variety of assistive methods to achieve better results and evaluate surgical outcomes in detail. This retrospective study aimed to evaluate the postoperative stability after bilateral sagittal split ramus osteotomy by volume rendering methods and to evaluate how postoperative stability differs depending on the type of surgical plate. Of the patients who underwent BSSRO, ten patients in each group (non-customized miniplate and customized miniplate) who met the inclusion criteria were selected. Preoperative and postoperative cone-beam computed tomography data were collected, and condylar morphological and landmark measurements were obtained using Checkpoint and OnDemand software, respectively. The postoperative condylar morphological dataset revealed no significant difference (p > 0.05) between the two groups. No significant difference (p > 0.05) was observed between the two groups in horizontal, vertical, or angular landmark measurements used to quantify operational stability. These results indicate that there is no difference in the surgical outcome between the patient-specific system and the conventional method, which will allow clinicians to take advantage of the patient-specific system for this surgical procedure, with favorable results, as with the conventional method.

Quantitative Analysis of Dual-Purpose, Patient-Specific Craniofacial Implants for Correction of Temporal Deformity

2015 ◽  
Vol 11 (2) ◽  
pp. 205-212 ◽  
Author(s):  
Shuting Zhong ◽  
Gary J Huang ◽  
Srinivas M Susarla ◽  
Edward W Swanson ◽  
Judy Huang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Dual Purpose ◽  
Temporal Asymmetry ◽  
Lateral Projection ◽  
Skull Defects ◽  
Computer Assisted Design ◽  
Onlay Technique

Abstract BACKGROUND The development of computer-assisted design, virtual modeling, and computed tomography has allowed precise customization of implants for patients who undergo neurosurgical or craniofacial surgery procedures. However, such techniques and implant designs have not adequately addressed temporal asymmetry due to postoperative bone resorption, temporalis muscle malposition/foreshortening, and/or temporal fat pad atrophy. OBJECTIVE We hypothesized that an alteration in customized craniofacial implant (CCI) design with a strategic extension inferolaterally and excessive material bulking would provide simultaneous reconstruction of coexisting temporal skull defects and therefore reduce the effect of soft tissue deformities. METHODS A single-surgeon, single-institution retrospective cohort study was performed to include 10 consecutive subjects who underwent cranioplasty reconstruction with modified implants during a 3-year period. Implants were placed with the use of our previously described pericranial-onlay technique. With the use of a computed tomography-based, computer-assisted design/manufacturing methodology, novel dual-purpose implants were designed to prevent and/or correct persistent temporal hollowing. The efficacy of the new CCI shape and design for cranial restoration of temporal symmetry was analyzed in both 2 and 3 dimensions. RESULTS In 2-dimensional analyses, the modified implant provided enhanced lateral projection (21%; 1.06 cm) in areas closest to the temporal arch. Three-dimensional volumetric analyses demonstrated that additional bulking totaled 24 ± 11 cm3 (range, 9-43 cm3), which essentially replaced 40 ± 13.7% (range, 26%-60%) of the absent temporal volume contributing to persistent temporal hollowing. CONCLUSION Computer-designed, dual-purpose CCIs can be safely created with unprecedented shape to prevent and/or eradicate postoperative temporal deformity.

Is Preoperative Planning for Hip Surgery Using Three-Dimensional Printed Models Associated with Improved Intra- and Postoperative Outcomes? A Systematic Review

2019 ◽  
Vol 03 (03) ◽  
pp. 151-160
Author(s):  
Michael J. Mosca ◽  
Pablo Castañeda
Keyword(s):  
3D Printing ◽  
Clinical Outcomes ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Postoperative Outcomes ◽  
Hip Surgery ◽  
Patient Specific ◽  
Original Research ◽  
Surgical Guides ◽  
3D Printed

AbstractUse of three-dimensional (3D) printed models for preoperative planning, patient-specific surgical guides, and implants in orthopaedic surgery is a burgeoning technology. It has not been established if 3D-printed models for preoperative planning are associated with improved clinical outcomes or if they are cost-effective for hip surgeries including total hip arthroplasty (THA), periacetabular osteotomy (PAO), proximal femoral osteotomy (PFO), and/or hip fractures. The purpose of this study was to conduct a systematic search and literature review to determine if preoperative planning for hip surgery using 3D-printed models was associated with improved intra- and postoperative outcomes. Specific aims were to determine the (1) types of applications and studies conducted, (2) types of 3D printing/materials used, (3) specific outcomes evaluated, (4) efficacy of 3D printing in planning for hip surgery, and (5) limitations of current research. The authors searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL, and PubMed from inception through July 2017. Original research publications were included if the primary purpose was to evaluate 3D-printed models' ability to assist with the planning of hip surgeries. Papers were excluded if they were reviews, abstracts, and not available in English, their models were not patient-specific, or their research did not evaluate surgery of the acetabulofemoral joint or pelvis. Of the 3,369 unique papers identified, 21 met inclusion criteria after full-text review. Among the included studies, six evaluated 3D printing in THA, seven in PAO/PFO, and eight in fracture repairs/reconstruction. The research included nine case reports, three case series, one retrospective uncontrolled study, six prospective uncontrolled studies, and two prospective controlled studies. 3D printed models resulted in: reduced intraoperative improvisation, operating room time, blood loss/transfusions, improved positioning of plates/screws/implants, clinical scores, measures of realignment, and functional status. Recent innovations in 3D printing are promising but unproven to improve clinical outcomes in hip surgeries due to limitations of published research. This may impact utilization and reimbursement of 3D-printed models in hip surgery. Studies of resource utilization, cost-effectiveness, and controlled trials with standardized methods and clinical outcomes of relevance are needed.

scholarly journals Mandibular Reconstruction Using ProPlan CMF: A Review

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1606835 ◽  
Author(s):  
Ryo Sasaki ◽  
Michael Rasse
Keyword(s):  
Computer Assisted Surgery ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Planning Service ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Computer Aided

ProPlan CMF (Depuy Synthes, Solothurn, Switzerland, and Materialise, Leuven, Belgium) is a computer-aided surgical virtual planning service using an online meeting with professional medical engineers and transfers patient-specific surgical guide to the virtual plan. Moreover, prebent reconstruction plates or patient-specific computer-aided manufacturing-fabricated reconstruction can also be used. This service started in 2011. Currently, it is widely used in Europe. Current status of mandibular reconstruction with ProPlan CMF vertical planning service with the surgical guide was reviewed. The accuracy was excellent in terms of contact of the osteotomized parts and the contact to the remaining skeleton. The authors found that currently, a small number of reports regarding the mandibular reconstruction with virtual planning service and surgical guides are available. These reports also have a small number of cases and short-term follow-up results. In this situation, this review revealed that (1) mainly the resection guides, cutting guides, and patient-specific mandible reconstruction plates were adequately well fitted to the surgical site intraoperatively, (2) the ischemic time might be more reduced than that of the conventional surgery (3) the accuracy of computer-assisted surgery in the mandibular reconstruction was clinically acceptable, and (4) condyle positions after the computer-assisted surgery was mainly normal. The higher additional cost than that of the conventional technique is presently an issue. Large-scale clinical studies and long-term follow-up studies are demanded.

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