Application of 3D‐printed Customized Guides in Subtalar Joint Arthrodesis

Duan, Xiaojun; Fan, Huaquan; Wang, Fuyou; He, Peng; Yang, Liu

doi:10.1111/os.12464

Cited by 23 publications

(21 citation statements)

References 40 publications

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“…activity limitation and support requirement, maximum walking distance, walking surfaces, gait abnormality, sagittal motion, hindfoot motion, and ankle stability), and 10 points of alignment [36]. Duan et al [23] demonstrated comparable AOFAS scores between the 3DPM and control group in the treatment of ankle deformities. In the study by Zhang et al [35], comparable AOFAS scores between the 3D printing group and the conventional group (87.4 vs. 84.7) were noted.…”

Section: Aofasmentioning

confidence: 99%

“…Previous studies have shown that the use of 3DPM is associated with decreased surgical time and intraoperative X-ray exposure, as well as increased operative accuracy and safety compared to traditional imaging in the treatment of ankle deformities [21,22]. Duan et al [23] found that preoperative planning with 3DPM facilitated accurate drilling of K-wires into the appropriate position, reduced the operation time and intraoperative radiation in 29 patients who underwent subtalar joint arthrodesis. A randomized controlled trial by Zheng et al [24] showed that 3DPMassisted surgical planning had shorter operation duration, less blood loss and X-ray exposure, as well as better anatomic reduction and clinical outcomes than conventional surgery in 100 patient with Pilon fractures.…”

Section: D Printed Modelsmentioning

confidence: 99%

“…A randomized trial by Zheng et al [24] showed shorter operation time in the 3DPM-assisted group than the conventional group (74 mins vs. 90 mins) in the treatment of Pilon fractures in 100 patients. Duan et al [23] noted shorter time for accurate drilling of a K-wire to the satisfactory position (2.1 mins vs. 4.6 mins) and fewer number of re-drills (2 cases vs. 8 cases) in 14 joints under 3DPM assistance than 16 joints using traditional method during subtalar joint arthrodesis. In addition, Corona et al [27] reported that the average surgical time in 9 patients who underwent 3DPM-assisted preoperative surgical planning was about half of the time in 10 patients with traditional planning (172 mins vs. 329 mins) in the treatment of post-traumatic tibial malunion and non-union using circular external xation.…”

Section: Operation Durationmentioning

confidence: 99%

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3D Printed Models Improve Surgical Planning for Correction of Severe Postburn Ankle Contracture With External Fixator

Han

Niu

Jiang

et al. 2020

Preprint

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Background: Gradual distraction with external fixators such as Ilizarov frame has been widely used for the treatment of severe postburn ankle contracture (PAC). However, the application of external fixator is complex and conventional surgical planning based on 2D imaging is compromised due to a lack of spatial geometry and tactile feedback. The purpose of this study was to evaluate the surgical planning with patient-specific 3D-printed models (3DPM) for the treatment of PAC with external fixators. Methods: A two-centered retrospective cohort study, composed of consecutive patients who underwent external fixation for the treatment of severe PAC, was implemented. Patients were divided into two cohorts (3DPM group vs. Control group) according to whether 3DPM was used for preoperative surgical planning. The primary outcome variable was operation duration. Other outcome variables included improvement in metatarsal-tibial angle (MTA), range of motion (ROM), American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications. Results: Between January 2008 and June 2018, ten patients with an average age of 23.8±14.1 yeas were treated for PAC at two centers. 3DPM were used for surgical planning in 5 patients. 3DPM group had significantly shorter operation duration than the control group (2±0.3 hours vs. 3.2±0.3 hours, p=0.0001). The comparison of preoperative, after removal of external fixator, and follow-up MTA, ROM, and AOFAS between the 3DPM and control group showed no significant differences. A plantigrade foot was achieved and gait was substantially improved in all patients at the final follow-up. Pin-tract infections occurred in 2 patients (one in each group) during distraction and were treated with wound care and oral antibiotics. Conclusion: The results of this study show that surgical planning using patient-specific 3DPM significantly reduced the operation duration while providing similar improvements in MTA, ROM, and AOFAS scores compared to traditional surgical planning for the correction of severe PAC with external fixators.

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Section: Aofasmentioning

confidence: 99%

Section: D Printed Modelsmentioning

confidence: 99%

Section: Operation Durationmentioning

confidence: 99%

See 1 more Smart Citation

3D Printed Models Improve Surgical Planning for Correction of Severe Postburn Ankle Contracture With External Fixator

Han

Niu

Jiang

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Several studies have demonstrated that patient specific instrumentation is accurate and reproducible performing total ankle arthroplasty [10,11]. 3D printed custom guides have also been designed for subtalar joint arthrodesis, and a recently published study found that these guides reduced operative time and radiation exposure from fluoroscopy [12].…”

Section: D Printing In Foot and Ankle Surgerymentioning

confidence: 99%

Clinical applications of custom 3D printed implants in complex lower extremity reconstruction

et al. 2020

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Background Three dimensional printing has greatly advanced over the past decade and has made an impact in several industries. Within the field of orthopaedic surgery, this technology has vastly improved education and advanced patient care by providing innovating tools to complex clinical problems. Anatomic models are frequently used for physician education and preoperative planning, and custom instrumentation can assist in complex surgical cases. Foot and ankle reconstruction is often complicated by multiplanar deformity and bone loss. 3D printing technology offers solutions to these complex cases with customized implants that conform to anatomy and patient specific instrumentation that enables precise deformity correction. Case presentation The authors present four cases of complex lower extremity reconstruction involving segmental bone loss and deformity – failed total ankle arthroplasty, talus avascular necrosis, ballistic trauma, and nonunion of a tibial osteotomy. Traditional operative management is challenging in these cases and there are high complication rates. Each case presents a unique clinical scenario for which 3D printing technology allows for innovative solutions. Conclusions 3D printing is becoming more widespread within orthopaedic surgery. This technology provides surgeons with tools to better tackle some of the more challenging clinical cases especially within the field of foot and ankle surgery.

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“…However, they do not actually address the deformity of the subtalar joint complex, and patients are faced with the risk of nonunion or malunion and a longer recovery time. Arthrodesis should be avoided if at all possible because of the loss of the shock‐absorbing function of the subtalar joint complex and the tendency to develop early degenerative arthritis in adjacent joints 4–6 . STA refers to the implantation of a device in the sinus tarsi to restrict excessive eversion of the subtalar joint and consequently correct the flatfoot deformity.…”

Section: Introductionmentioning

confidence: 99%

Mid‐term Results of Subtalar Arthroereisis with Talar‐Fit Implant in Pediatric Flexible Flatfoot and Identifying the Effects of Adjunctive Procedures and Risk Factors for Sinus Tarsi Pain

Wang

Chen

et al. 2020

Orthopaedic Surgery

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Objectives To (i) report the mid‐term outcomes of subtalar arthroereisis using Talar‐Fit implant for the treatment of flexible flatfoot patients; (ii) compare clinical and radiographic outcomes between arthroereisis with and without adjunctive operative procedures to investigate the effects of adjuncts on the outcomes; and (iii) analyze the risk factors associated with sinus tarsi pain, which is the most common postoperative complication of arthroereisis. Methods Thirty‐one flexible flatfoot children and adolescents (46 feet) treated with subtalar arthroereisis using Talar‐Fit implant from June 2014 to May 2019 were retrospectively analyzed. The feet were divided into four treatment groups: (i) arthroereisis alone, (ii) arthroereisis with gastrocnemius recession, (iii) arthroereisis with Kidner procedure, and (iv) arthroereisis with gastrocnemius recession and Kidner procedure. Clinical function was evaluated based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score. The following angles were measured for radiographic evaluation: talar‐first metatarsal angle, calcaneal pitch angle, and talar declination angle on the lateral view; and talar‐first metatarsal angle, talocalcaneal angle, and anteroposterior talonavicular coverage angle on the anteroposterior (AP) view. The paired Student's t‐test was used to compare the pre‐ and postoperative angular measurements and AOFAS scores. The Wilcoxon rank‐sum test was undertaken to determine the outcome differences among four treatment groups. Multivariate logistic regression analysis was used to analyze risk factors for sinus tarsi pain. P value <0.05 is considered statistically significant. Results The mean follow‐up of the feet was 32.8 months (range, 10–71 months). The mean AOFAS score significantly improved from 55.5 ± 14.5 preoperatively to 86.3 ± 9.9 (P < 0.001). Comparison of radiographic outcomes showed that the lateral talar‐first metatarsal angle decreased by a mean of 19.1° ± 11.9° (P < 0.001), the calcaneal pitch angle increased by a mean of 5.4° ± 3.4° (P < 0.001), the talar declination angle decreased by a mean of 14.8° ± 9.9° (P < 0.001), the AP talar‐first metatarsal angle decreased by a mean of 15.6° ± 10.3° (P < 0.001), the AP talocalcaneal angle decreased by a mean of 7.2° ± 8.3° (P = 0.001), and the AP talonavicular coverage angle decreased by a mean of 20.4° ± 9.0° (P < 0.001). There were no statistically significant differences with regard to AOFAS score and all angle measurements on both the AP and lateral views among the four treatment groups. There was one dislocation case caused by a fall 6 weeks after surgery, which was treated nonoperatively. The incidence of sinus tarsi pain was 13% and logistic regression analysis indicated that patients with a longer distance from the tail end of the implant to the lateral calcaneal wall had 38.8% greater odds of developing sinus tarsi pain. Conclusions The mid‐term clinical and radiographic results were satisfactory in patients who underwent the subtalar arthroereisis procedur...

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Application of 3D‐printed Customized Guides in Subtalar Joint Arthrodesis

Cited by 23 publications

References 40 publications

3D Printed Models Improve Surgical Planning for Correction of Severe Postburn Ankle Contracture With External Fixator

3D Printed Models Improve Surgical Planning for Correction of Severe Postburn Ankle Contracture With External Fixator

Clinical applications of custom 3D printed implants in complex lower extremity reconstruction

Mid‐term Results of Subtalar Arthroereisis with Talar‐Fit Implant in Pediatric Flexible Flatfoot and Identifying the Effects of Adjunctive Procedures and Risk Factors for Sinus Tarsi Pain

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