Patient-specific instrument can achieve same accuracy with less resection time than navigation assistance in periacetabular pelvic tumor surgery: a cadaveric study

Wong, Kwok-Chuen; Sze, Kwan-Yik; Wong, Irene; Wong, Chung-Ming; Kumta, S. M.

doi:10.1007/s11548-015-1250-x

Cited by 76 publications

(84 citation statements)

References 25 publications

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“…Among the previous studies, the only study that presented quantitative measurement of the in vivo accuracy of the navigation system reported an average of 2.5 mm cutting error using the navigation system . A previous study comparing the PSI and the navigation system showed similar accuracy with the 3D‐printed PSI and the navigation system . In addition, the 3D‐printed PS‐BTRG can be duplicated to shape a structural bone allograft, which has remained a challenge when using a navigation system .…”

Section: Discussionmentioning

confidence: 99%

“…Three‐dimensional (3D)–printing technology allows for an advanced approach to limb salvage surgery in both components. In the first step of limb salvage surgery, 3D‐printing technology has been mainly used with the use of a 3D‐printed patient‐specific instrument (PSI) . For the reconstruction of bone defects, 3D‐printing technology has been utilized in manufacturing custom‐made implants, but only a few studies have reported on the surgical outcomes with short‐term follow‐up …”

Section: Introductionmentioning

confidence: 99%

“…When possible, joints, normal bone stock, and important ligaments and tendons need to be maximally preserved to ensure postoperative function of the salvaged limb. To achieve a wide bone margin and maximize limb function after limb salvage surgery, various techniques have been attempted, such as surgery with a fluoroscopic radiologic imaging system, a navigation system, an augmented reality system, and PSI, including a 3D‐printed patient‐specific bone tumor resection guide (PS‐BTRG) . The intraoperative navigation system is limited because of its difficult and time‐consuming registration procedure and extensive learning curve.…”

Section: Introductionmentioning

confidence: 99%

“…In the first step of limb salvage surgery, 3D-printing technology has been mainly used with the use of a 3D-printed patient-specific instrument (PSI). 1,[6][7][8] For the reconstruction of bone defects, 3D-printing technology has been utilized in manufacturing custom-made implants, but only a few studies have reported on the surgical outcomes with short-term follow-up. 1,[7][8][9][10] A critical aspect in the wide excision of a bone tumor is cutting the bone to achieve a sufficient margin around the tumor.…”

Section: Introductionmentioning

confidence: 99%

“…To achieve a wide bone margin and maximize limb function after limb salvage surgery, various techniques have been attempted, such as surgery with a fluoroscopic radiologic imaging system, a navigation system, 2,11-15 an augmented reality system, 16 and PSI, including a 3D-printed patient-specific bone tumor resection guide (PS-BTRG). 1,[6][7][8] The intraoperative navigation system is limited because of its difficult and time-consuming registration procedure and extensive learning curve. Additionally, the augmented reality system is still in the experimental stages and requires further development before application in actual patients.…”

Section: Introductionmentioning

confidence: 99%

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Bone tumor resection guide using three‐dimensional printing for limb salvage surgery

Park

Kang

Lim

et al. 2018

Journal of Surgical Oncology

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Background and Objectives The three‐dimensional (3D)‐printed bone tumor resection guide can be personalized for a specific patient and utilized for bone tumor surgery. It is noninvasive, eidetic, and easy to use. We aimed to categorize the use of the 3D‐printed guide and establish in vivo accuracy data. Methods We retrospectively reviewed 12 patients, who underwent limb salvage surgery using the 3D‐printed guide at a single institution. To confirm the achievement of a safe bone margin, we compared the actual and planned distances between the cutting surface and tumor, which were reported in the final pathological report and measured from the same virtual cutting plane using graphical data of the cutting guide design, respectively. Results The use of the 3D‐printed guide was categorized as follows: (a) wide excision only, (b) wide excision and biological reconstruction with a structural bone allograft shaped in accordance with the 3D‐printed guide, and (c) wide excision and reconstruction with a 3D‐printed personalized implant. The maximal cutting error was 3 mm. Conclusions The 3D‐printed resection guide is easy to use and shows promise in the field of orthopedic oncology, with its application in bone tumor resection and reconstruction with a structural bone allograft or 3D‐printed implant.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Bone tumor resection guide using three‐dimensional printing for limb salvage surgery

Park

Kang

Lim

et al. 2018

Journal of Surgical Oncology

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A novel method of light projection and modular jigs to improve accuracy in bone sarcoma resection

Dai

Mustahsan

et al. 2022

Journal Orthopaedic Research

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We developed a novel method using a combined light‐registration/light‐projection system along with an off‐the‐shelf, instant‐assembly modular jig construct that could help surgeons improve bone resection accuracy during sarcoma surgery without many of the associated drawbacks of 3D printed custom jigs or computer navigation. In the novel method, the surgeon uses a light projection system to precisely align the assembled modular jig construct on the bone. In a distal femur resection model, 36 sawbones were evenly divided into 3 groups: manual‐resection (MR), conventional 3D‐printed custom jig resection (3DCJ), and the novel projector/modular jig (PMJ) resection. In addition to sawbones, a single cadaver experiment was also conducted to confirm feasibility of the PMJ method in a realistic operative setting. The PMJ method improved resection accuracy when compared to MR and 3DCJ, respectively: 0.98 mm versus 7.48 mm (p < 0.001) and 3.72 mm (p < 0.001) in mean corner position error; 1.66 mm versus 9.70 mm (p < 0.001) and 4.32 mm (p = 0.060) in mean maximum deviation error; 0.79°–4.78° (p < 0.001) and 1.26° (p > 0.999) in mean depth angle error. The PMJ method reduced the mean front angle error from 1.72° to 1.07° (p = 0.507) when compared to MR but was slightly worse compared to 0.61° (p = 0.013) in 3DCJ. The PMJ method never showed an error greater than 3 mm, while the maximum error of other two control groups were almost 14 mm. Similar accuracy was found with the PMJ method on the cadaver. A novel method using a light projector with modular jigs can achieve high levels of bone resection accuracy, but without many of the associated drawbacks of 3D printed jigs or computer navigation technology.

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Sacroiliac joint cut accuracy: Comparing new technologies in an idealized sawbones model

Siegel

Balach

Sweeney

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: The anatomical complexity of the pelvis creates challenges for orthopaedic oncologists to accurately and safely resect tumors involving the sacroiliac joint. Current technology may help overcome these obstacles. Methods: Four fellowship-trained orthopaedic oncologists performed 22 all-posterior sacroiliac cuts using freehand, computerized navigation, and patient-specific cutting guides on a Sawbones male pelvis model. Cut accuracies to preoperative planned margins were analyzed via a high-resolution optical scanner. Soft tissue damage was determined by visually inspecting the Sawbones foam placed on the far side of the cut. Results: Within 5 mm of the margins, the freehand technique resulted in 67.0% cut accuracy, the navigation technique had 71.1%, and the patient-specific cutting guide technique had 85.6% (P = .093). Within 2 mm, the techniques showed an accuracy of 25.8%, 32.5%, and 47.5%, respectively (P = .022). Regarding soft tissue damage, the freehand technique exhibited minimal penetration damage for 16.7% of the cuts, while navigation and patient-specific guide techniques exhibited 25.0% and 75.0%, respectively (P = .046). Years of surgical experience of the operator (1-7) did not influence the cut accuracy for any method. Conclusions: Under ideal conditions, patient-specific guide technology possesses the same or better accuracy as other cutting techniques as well as the circumvention of soft tissue damage.

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Patient-specific instrument can achieve same accuracy with less resection time than navigation assistance in periacetabular pelvic tumor surgery: a cadaveric study

Cited by 76 publications

References 25 publications

Bone tumor resection guide using three‐dimensional printing for limb salvage surgery

Bone tumor resection guide using three‐dimensional printing for limb salvage surgery

A novel method of light projection and modular jigs to improve accuracy in bone sarcoma resection

Sacroiliac joint cut accuracy: Comparing new technologies in an idealized sawbones model

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