scholarly journals Clinical application of multiple 3D-printed guide plates for precise reduction and fixation of comminuted patellar fractures

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097208
Author(s):  
Zhi-Sheng Long ◽  
Fei-Peng Gong ◽  
Xie-Ping Dong ◽  
Jing-Tang Li
Keyword(s):  
Knee Joint ◽  
Articular Surface ◽  
Good Condition ◽  
Three Dimensional ◽  
Operation Time ◽  
Left Knee ◽  
Preoperative Imaging ◽  
Anatomical Landmarks ◽  
3D Printed ◽  
Patellar Fractures

Because of the lack of anatomical landmarks during reduction of multiple articular surfaces and fragments in comminuted patellar fractures, loss of bone fragments or aggravation of soft tissue and ligament injuries readily occurs. In the present case, we used multiple three-dimensional (3D)-printed guide plates to reduce and fix a comminuted patellar fracture. A 22-year-old man was hospitalized for 2 days because of left knee joint pain and limited movement caused by a traffic accident. Preoperative imaging revealed a comminuted fracture of the left patella (type 34-C3 according to the AO/OTA classification). Throughout a 2-year follow-up, the patient remained in generally good condition with no significant limitation of his left knee joint activity. Application of multiple 3D-printed guide plates is a safe and effective auxiliary technique for the treatment of comminuted patellar fractures. This novel technique can shorten the operation time, reduce the number of fluoroscopic procedures, and ensure fracture healing and recovery of knee joint function through reliable reduction of the articular surface.

scholarly journals 3D Printed Personalized Guide Plate in the Femoral Head Core Decompression

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Liangliang Cheng ◽  
Xing Qiu ◽  
Lei Yang ◽  
Chi Xiao ◽  
Baoyi Liu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Three Dimensional ◽  
Core Decompression ◽  
Operation Time ◽  
Drill Hole ◽  
Needle Insertion ◽  
Pathological Examination ◽  
Anatomic Structure ◽  
Guide Plate ◽  
3D Printed

Objective. To investigate the feasibility of using 3D printed personalized guide plates in core decompression procedures for the treatment of osteonecrosis of the femoral head (ONFH). Methods. The clinical data of 8 patients undergoing femoral head core decompression from January to December 2019 were analyzed retrospectively. Three-dimensional (3D) images of the patients were reconstructed from the CT scan data taken preoperatively. From the data obtained, puncture position, drill hole, and depth were evaluated, and individualized 3D puncture guide plates were designed using Mimics 21.0 software. During the operation, the needle went through the hole of the guide plate, the depth of the drill was controlled, and the obtained bone tissues were sent for pathological evaluation. Intraoperative X-ray and postoperative pathological results were used to evaluate the success of the puncture. Results. The individualized guide plates used for core compression on the 8 patients were well fitted with the anatomic structure of the puncture site, and the direction and depth of the needle insertion were consistent with the preoperative design. The operation time was about 15-22 mins. The position of the decompression tunnel was the same as the designed plate. The postoperative pathology showed necrotic bone tissue. There were no postoperative complications such as infection, bleeding, and fracture. Conclusion. The 3D printed individualized guide plate can simplify core decompression and would make this procedure more accurate, safe, and quick, in addition to obtaining necrotic tissues for pathological examination.

scholarly journals Three-dimensional printed porous tantalum prosthesis for treating inflammation after total knee arthroplasty in one-stage surgery – a case report

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051989128
Author(s):  
Fuyou Wang ◽  
Hao Chen ◽  
Pengfei Yang ◽  
Aikeremujiang Muheremu ◽  
Peng He ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Chronic Inflammation ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Bone Defects ◽  
Left Knee ◽  
Severe Osteoporosis ◽  
Porous Tantalum ◽  
3D Printed ◽  
Total Knee

Chronic inflammation and bone defects after total knee arthroplasty are a challenge for the orthopedic surgeon. There have been few reports on application of a three-dimensional (3D) printed porous tantalum prosthesis in such situations. We report an 83-year-old female patient who presented to our clinic with consistent pain of the left knee for 10 years and a severe decline in mobility for 2 years. Chronic inflammation, loosening of a tibial prosthesis with a bone defect, and severe osteoporosis were diagnosed. The patient was treated with computer designed and manufactured, personalized, 3D printed porous pure tantalum pad-assisted left total knee arthroplasty. The surgery went smoothly and the patient achieved a satisfactory recovery after surgery. A 3D printed porous tantalum prosthesis can be used to reconstruct tibial bone defects in patients with chronic inflammation after joint replacement surgeries.

THE EFFECTS OF EARLY SYNOVECTOMY IN ACUTE SEPTIC ARTHRITIS: AN EXPERIMENTAL STUDY WITH STAPHYLOCOCCUS AUREUS IN THE RABBIT KNEE JOINT

2002 ◽  
Vol 06 (03n04) ◽  
pp. 171-180 ◽  
Author(s):  
Remzi A. Özerdemoglu ◽  
Ufuk Aydinli ◽  
Hüseyin Yorgancigil ◽  
Ömer Yerci
Keyword(s):  
Staphylococcus Aureus ◽  
Articular Cartilage ◽  
Knee Joint ◽  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Early Stage ◽  
Articular Surface ◽  
Left Knee ◽  
Treatment Modalities ◽  
Surgical Drainage

The objective of this study is to analyze the effects and benefits of subtotal synovectomy in the early stage of septic arthritis. seventy rabbits with septic arthritis of the left knee joint were treated at 24 or 72 hours after inoculation of Staphylococcus aureus, with different treatment modalities, including antibiotic therapy, arthrotomy, irrigation, and synovectomy. At the end of the 6th week, the knee joints were removed and examined both macroscopically and histologically. It was discovered that there was more significant degeneration at the articular surface of the femur than that of the tibia. antibiotic therapy alone was found to be insufficient to prevent the degeneration of articular cartilage. performing subtotal synovectomy had no statistically significant effect 24 hours after the inoculation of bacteria. However, adding subtotal synovectomy to the surgical drainage 72 hours after inoculation resulted in significantly lesser degeneration of the articular cartilage. Sufficient drainage and irrigation of the joint associated with antibiotic treatment seems to be an adequate choice of treatment at the very early stage of septic arthritis. However, in established septic arthritis, adding subtotal synovectomy to the surgical drainage resulted in significantly lesser degeneration of the articular cartilage.

scholarly journals A choice of surgical approach for osteosynthesis in fractures of the lateral tibial condyle

2020 ◽  
pp. 10-20
Author(s):  
I. G. Belenky ◽  
A. Yu. Kochish ◽  
M. A. Kislitsyn ◽  
B. A. Mayorov
Keyword(s):  
Knee Joint ◽  
Plate Osteosynthesis ◽  
Articular Surface ◽  
Stress Test ◽  
Operation Time ◽  
Surgical Approaches ◽  
Anterolateral Approach ◽  
Valgus Stress ◽  
Intraarticular Fractures ◽  
Tibial Condyle

Intention. To conduct a comparative analysis of the dynamics of the consolidation of intraarticular fractures of the posterolateral parts of the lateral tibial condyle, the anatomical and functional outcomes of surgical treatment of these patients after plate osteosynthesis with traditional anterolateral and posterolateral transfibular surgical approaches as well.Methodology. A comparative prospective study of the effectiveness of osteosynthesis in patients with fractures of the posterolateral part of lateral tibial condyle in two compatible clinical groups was performed in dynamics for periods of 7–10 days, 1, 3, 6 and 9 months after surgery. In the first group (25 patients), bone osteosynthesis was performed from traditional anterolateral approach (TALA), and in the second group (20 patients), from the posterolateral transfibular approach (PLTFA). The average duration of osteosynthesis operations was compared. The displacements of fragments of the articular surface of the lateral tibial condyle, the indices of the KSS and Lysholm scales, the results of measurements of the angle of flexion and valgus stress test of the knee joint were evaluated. Data processing was performed using the Data Analysis and Chart Master modules (Excel), the Basic Statistics / Tables module (Statistic for Windows) as well.Results and Discussion. In the PLTFA group, the average operation time was (81.0 ± 8.5) minutes (from 67 to 96 minutes), in the TALA group, the duration of operations was 35.8 % longer and averaged (110 ± 5.2) minutes (from 82 to 125 minutes) (p < 0.05). The values of the KSS and Lysholm scales in dynamics showed a steady and statistically significant (p < 0.01) increase with increasing time after surgery without significant differences between the groups. The angle of flexion of the knee joint increased more rapidly during the first three months, then the rate decreased from 6 to 9 months (p < 0.05) without significant differences between the groups. The frequency of displacements of fragments of the articular surface in the first group was statistically significantly (p < 0.05) higher than in the second group. Differences in the valgus-stress test indices in both groups reached a maximum after 9 months – 52 and 30 %, respectively.Conclusion. With PLTFA, surgery duration decreases, articular surface fragments are better reduced, and their subsequent displacement at the stages of treatment is less likely; therefore, this approach is preferable for osteosynthesis of fractures of the posterolateral parts of the lateral tibial condyle.

Quantification of Tumor Blush of Highly Vascularized Tumors with Slow Feeding System: Representative Use for Giant Pituitary Adenomas

2021 ◽  
Author(s):  
Yoshikazu Ogawa ◽  
Kenichi Sato ◽  
Toshiki Endo ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Adenomas ◽  
Imaging Techniques ◽  
Cone Beam Ct ◽  
Three Dimensional ◽  
Region Of Interest ◽  
Operation Time ◽  
Preoperative Imaging ◽  
Ct Scanner ◽  
Cavernous Sinus Invasion ◽  
Giant Pituitary Adenomas

abstract Background Modern imaging techniques can identify adverse factors for tumor removal such as cavernous sinus invasion before surgery, but surgeries for giant pituitary adenomas often reveal discrepancies between preoperative imaging and intraoperative findings because pituitary adenomas have feeding arteries with narrow diameters. Current imaging methods are not suitable for tumors with not only large vascular beds but also slow arterial filling. Patients and Methods This prospective study recruited 13 male subjects and 9 female subjects with giant pituitary adenomas between November 2011 and 2018. All the patients were investigated with three-dimensional magnetic resonance (MR) imaging, bone image computerized tomography (CT), and digital subtraction angiography (DSA) using a C-arm cone-beam CT scanner with a flat-panel detector and 50% diluted contrast medium. Fine angioarchitecture was evaluated and the tumor blush was quantified using newly developed region of interest (ROI) analysis to establish surgical strategies. Results Seven patients demonstrated no or very faint tumor blushes. In these patients, feeding arteries run centripetally from the surface of the tumor. Fifteen patients showed significant tumor blushes, and the feeding arteries penetrated centrifugally from the inferoposterior pole to the upper pole of the tumor. All the patients were treated according to the angiographic information with successful hemostasis. The patients showed improvement and/or disappearance of the neurologic deficits. The faint and significant blush groups showed significant differences in intraoperative bleeding (p < 0.01) and operation time (p < 0.05). Conclusion Specialized evaluation focused on vascularization is required for successful therapy of giant pituitary adenomas.

Design and Analysis of a Novel Lightweight, Energy Economic Powered Knee Orthotic Device

2019 ◽  
Vol 13 (3) ◽  
Author(s):  
Saikat Sahoo ◽  
Aditya Jain ◽  
Dilip Kumar Pratihar
Keyword(s):  
Knee Joint ◽  
Power Consumption ◽  
Three Dimensional ◽  
Fast Response ◽  
Design Parameters ◽  
Angular Deviation ◽  
Natural Behavior ◽  
Orthotic Device ◽  
3D Printed ◽  
Novel Design

The task of a powered knee orthotic device (PKOD) is to assist the knee joint so that its natural behavior can be restored. The key features of a PKOD that may help to regain such characteristics are low power consumption, fast response, compactness, and lightweight. This study proposes a novel design of PKOD, where we have focused on the betterment of the mentioned features with the help of a new mechanism, namely a four-bar controlled compliance actuator (FCCA). In FCCA, instead of using the widely used screw transmission mechanism, a four-bar mechanism is used to modify the joint's angular deviation and stiffness. The main advantages of using FCCA over other existing mechanisms are to reduce the power consumption by amplification of input motor torque and to achieve a faster response at the same time, and these are achieved by utilizing a simple four-bar mechanism. In the proposed design, FCCA controls both the stiffness of the artificial knee joint using a compliance mechanism as well as knee flexion with the help of a pulley arrangement. A three-dimensional (3D)-printed prototype of the proposed design has been developed, after optimizing the inherent design parameters. Simulation and experimental analysis are carried out in order to justify the performance of the proposed PKOD. The results have shown strong agreement with that obtained using analytical study and optimization. Moreover, the torque amplification is achieved, as desired.

The Effects of a Functional Three‐dimensional (3D) Printed Knee Joint Simulator in Improving Anatomical Spatial Knowledge

2019 ◽  
Vol 12 (6) ◽  
pp. 610-618 ◽  
Author(s):  
Bohong Cai ◽  
Kanagasuntheram Rajendran ◽  
Boon Huat Bay ◽  
Jieying Lee ◽  
Ching‐Chiuan Yen
Keyword(s):  
Knee Joint ◽  
Three Dimensional ◽  
Spatial Knowledge ◽  
3D Printed

scholarly journals Three‐dimensional‐printed customized prosthesis for pubic defect: clinical outcomes in 5 cases at a mean follow‐up of 24 months

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuqi Zhang ◽  
Li Min ◽  
Minxun Lu ◽  
Jie Wang ◽  
Yitian Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Clinical Outcomes ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Operation Time ◽  
Pubic Bone ◽  
Type Iii ◽  
3D Printed ◽  
The Mean

Abstract Background Pubic defects resulting from type III hemipelvectomy are commonly not reconstructed due to the need to preserve the weight-bearing axis. However, the opening of the anterior pelvic ring will inevitably lead to increased pelvic instability. To improve long-term pelvic stability, three-dimensional (3D)-printed customized prostheses were designed to reconstruct pubic defects. This study presents and evaluates the short-term clinical outcomes and complications from the use of this construct. Methods Five patients who underwent type III hemipelvectomy and 3D-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analysed. Operation time and blood loss during the operation were recorded. Local and functional recovery was assessed. Prosthetic position and osseointegration were evaluated. Oncology results and complications were recorded. Results The prostheses consisted of three with stems and two without. The mean follow-up time was 23.6 months. At the last follow-up, all five patients were alive with no evidence of disease. No deep infections or local recurrence had occurred. The mean blood loss and mean intraoperative time were 1680 ml and 294 min, respectively. The mean functional MSTS score at the final follow-up was 29.8. Fretting wear around the prosthetic stem was found in 3 patients, while bone wear on the normal-side pubis was found in 2 patients. Osseointegration was observed in all patients. Conclusions 3D-printed customized prostheses for reconstructing pubic bone defects after type III hemipelvectomy showed acceptable early outcomes. The good outcomes were inseparable from the precision prosthesis design, strict surgical procedures, and sensible postoperative management.

scholarly journals Toward a patient-specific tissue engineered vascular graft

2018 ◽  
Vol 9 ◽  
pp. 204173141876470 ◽  
Author(s):  
Cameron Best ◽  
Robert Strouse ◽  
Kan Hor ◽  
Victoria Pepper ◽  
Amy Tipton ◽  
...  
Keyword(s):  
Vascular Graft ◽  
Mononuclear Cells ◽  
Three Dimensional ◽  
Preoperative Imaging ◽  
Patient Specific ◽  
Three Dimensional Printing ◽  
Fused Deposition ◽  
3D Printed ◽  
Specific Tissue ◽  
Dimensional Printing

Integrating three-dimensional printing with the creation of tissue-engineered vascular grafts could provide a readily available, patient-specific, autologous tissue source that could significantly improve outcomes in newborns with congenital heart disease. Here, we present the recent case of a candidate for our tissue-engineered vascular graft clinical trial deemed ineligible due to complex anatomical requirements and consider the application of three-dimensional printing technologies for a patient-specific graft. We 3D-printed a closed-disposable seeding device and validated that it performed equivalently to the traditional open seeding technique using ovine bone marrow–derived mononuclear cells. Next, our candidate’s preoperative imaging was reviewed to propose a patient-specific graft. A seeding apparatus was then designed to accommodate the custom graft and 3D-printed on a commodity fused deposition modeler. This exploratory feasibility study represents an important proof of concept advancing progress toward a rationally designed patient-specific tissue-engineered vascular graft for clinical application.

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