3D‐printed, patient‐specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement

Abstract

Objectives The purpose of this cadaveric study was to determine whether patient‐specific guides (PSGs) improve the accuracy of tibial and femoral cut alignment in canine total knee replacement (TKR), as compared with generic cutting guides. Study design Original research. Animals Sixteen pelvic limbs from skeletally mature medium‐ to large‐breed canine cadavers. Methods Specimens were randomly allocated to one of two groups (PSG or Generic; N = 8/group). In the Generic group, femoral and tibial ostectomies were made using the standard canine TKR femoral cutting blocks and tibial alignment guide. In the PSG group, the cuts were made using a series of custom 3D‐printed cutting guides. “Planned” and “actual” tibial and femoral cut alignments were compared in the frontal and sagittal planes, and errors were calculated by subtracting actual from planned values. Results Use of 3D‐printed PSGs improved tibial cut alignment in the frontal plane but not the sagittal plane. PSGs also improved the alignment of the cranial and distal femoral ostectomies but did not impact varus‐valgus alignment. Conclusions These findings support the use of PSGs for TKR in dogs. Clinical trials are now needed to determine whether the benefits of PSGs translate into measurable improvements in joint function and implant longevity. Clinical significance PSGs have the potential to improve femoral and tibial component alignment in canine TKR.

Patient-Specific 3D-Printed Osteotomy Guides and Titanium Plates for Distal Femoral Deformities in Dogs with Lateral Patellar Luxation

“…In veterinary medicine, the use of 3D stereolithography has been reported in the literature for planning the correction of complex limb deformities or for fracture treatment [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. Optimal surgical management requires accurate characterization of the deformity, adequate preoperative planning and careful and precise intraoperative execution.…”

“…Unlike generic cutting guides, which are designed based on average reference values, PSGs allow for customized bone cuts, reducing the use of intra-operative diagnostics and operating time, increasing accuracy of bone cuts and allowing for precise correction of complex deformities. In veterinary medicine, the use of PSGs has been described in the treatment of numerous orthopedic conditions, both spinal and appendicular, including corrective osteotomies for tibial and femoral deformities [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. The aim of this study was to describe the restoration of alignment in the sagittal, frontal and transverse planes in two patients with grade IV LPL treated with distal femoral trapezoid osteotomies (DF-TO) using VSP and patient-specific 3D-printed osteotomy guides and titanium plates.…”