scholarly journals Clinical Experience Using a 3D-Printed Patient-Specific Instrument for Medial Opening Wedge High Tibial Osteotomy

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Jesse Chieh-Szu Yang ◽  
Cheng-Fong Chen ◽  
Chu-An Luo ◽  
Ming-Chau Chang ◽  
Oscar K. Lee ◽  
...  

Purpose. High tibial osteotomy (HTO) has been adopted as an effective surgery for medial degeneration of the osteoarthritis (OA) knee. However, satisfactory outcomes necessitate the precise creation and distraction of osteotomized wedges and the use of intraoperative X-ray images to continually monitor the wedge-related manipulation. Thus HTO is highly technique-demanding and has a high radiation exposure. We report a patient-specific instrument (PSI) guide for the precise creation and distraction of HTO wedge. Methods. This study first parameterized five HTO procedures to serve as a design rationale for an innovative PSI guide. Preoperative X-ray and computed tomography- (CT-) scanning images were used to design and fabricate PSI guides for clinical use. The weight-bearing line (WBL) of the ten patients was shifted to the Fujisawa’s point and instrumented using the TomoFix system. The radiological results of the PSI-guided HTO surgery were evaluated by the WBL percentage and tibial slope. Results. All patients consistently showed an increased range of motion and a decrease in pain and discomfort at about three-month follow-up. This study demonstrates the satisfactory accuracy of the WBL adjustment and tibial slope maintenance after HTO with PSI guide. For all patients, the average pre- and postoperative WBL are, respectively, 14.2% and 60.2%, while the tibial slopes are 9.9 and 10.1 degrees. The standard deviations are 2.78 and 0.36, respectively, in postoperative WBL and tibial slope. The relative errors of the pre- and postoperative WBL percentage and tibial slope averaged 4.9% and 4.1%, respectively. Conclusion. Instead of using navigator systems, this study integrated 2D and 3D preoperative planning to create a PSI guide that could most likely render the outcomes close to the planning. The PSI guide is a precise procedure that is time-saving, radiation-reducing, and relatively easy to use. Precise osteotomy and good short-term results were achieved with the PSI guide.

2016 ◽  
Vol 4 (2) ◽  
pp. 232596711663074 ◽  
Author(s):  
Hiroyasu Ogawa ◽  
Kazu Matsumoto ◽  
Takahiro Ogawa ◽  
Kentaro Takeuchi ◽  
Haruhiko Akiyama

2014 ◽  
Vol 24 (11) ◽  
pp. 3661-3667 ◽  
Author(s):  
Y. Akamatsu ◽  
M. Sotozawa ◽  
H. Kobayashi ◽  
Y. Kusayama ◽  
K. Kumagai ◽  
...  

2018 ◽  
Vol 51 ◽  
pp. 17-25 ◽  
Author(s):  
Marianne S. Black ◽  
Agnes G. d'Entremont ◽  
Robert G. McCormack ◽  
Gregory Hansen ◽  
Derek Carr ◽  
...  

Author(s):  
Dong Won Suh ◽  
Kyung Wook Nha ◽  
Seung Beom Han ◽  
Kuhoang Cheong ◽  
Bong Soo Kyung

AbstractFew clinical studies have compared uniplane high tibial osteotomy (HTO) with biplane HTO. The study aim was to compare the radiological and clinical results of uniplane HTO and biplane HTO, especially in terms of the increase in the posterior tibial slope (PTS). Medial opening-wedge HTO patients' medical records and radiological results from a single institution were retrospectively reviewed. Pre- and postoperative serial radiographs, including the Rosenberg, lateral view, and standing anteroposterior view of the whole lower extremity, magnetic resonance imaging at postoperative day 2, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at postoperative 2 years were reviewed to evaluate radiological and clinical results, including the change in PTS. A total of 61 knees, including 34 for uniplane and 27 for biplane HTOs, were enrolled. There were no significant differences in the pre- and postoperative mechanical angles or incidences of the lateral hinge fractures, and all patients showed complete union at postoperative 2 years. The PTS was increased more in the biplane group than in the uniplane group (3.1 ± 2.6 in biplane vs. 0.8 ± 1.7 in uniplane, p < 0.05). The WOMAC scores were 72 ± 9.3 in the uniplane and 75 ± 5.8 in the biplane group (not significant). The increase in PTS was lower in uniplane medial opening HTO than in biplane HTO.


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