Single cut distal femoral osteotomy for correction of femoral torsion and valgus malformity in patellofemoral malalignment - proof of application of new trigonometrical calculations and 3D-printed cutting guides

Imhoff, Florian B.; Schnell, Joscha; Magaña, Alejandro; Diermeier, Theresa; Scheiderer, Bastian; Braun, Sepp; Arciero, Robert A.; Beitzel, Knut

doi:10.1186/s12891-018-2140-5

Cited by 27 publications

(12 citation statements)

References 38 publications

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“…In a cadaveric model, Kaiser et al demonstrated that femoral derotational osteotomy has a significant impact on patellar tilt and axial plane engagement with a modest change in the TT–TG distance [ 113 ]. Several studies have evaluated the use of 3D-printed cutting guides both in cadaveric specimens and in vivo with promising results which may serve to provide precise and reproducible osteotomy correction in multiple planes with less radiation exposure to patients [ 114 , 115 , 116 , 117 , 118 , 119 ]. Our preferred technique is a midshaft femoral derotational osteotomy over an antegrade intramedullary nail.…”

Section: Treatmentmentioning

confidence: 99%

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

Palmer

Podeszwa

Wilson

et al. 2021

JCM

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Patellofemoral instability (PFI) encompasses symptomatic patellar instability, patella subluxations, and frank dislocations. Previous studies have estimated the incidence of acute patellar dislocation at 43 per 100,000 children younger than age 16 years. The medial patellofemoral ligament (MPFL) complex is a static soft tissue constraint that stabilizes the patellofemoral joint serving as a checkrein to prevent lateral displacement. The causes of PFI are multifactorial and not attributed solely to anatomic features within the knee joint proper. Specific anatomic features to consider include patella alta, increased tibial tubercle–trochlear groove distance, genu valgum, external tibial torsion, femoral anteversion, and ligamentous laxity. The purpose of this paper is to provide a review of the evaluation of PFI in the pediatric and adolescent patient with a specific focus on the contributions of coronal and transverse plane deformities. Moreover, a framework will be provided for the incorporation of bony procedures to address these issues.

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Section: Treatmentmentioning

confidence: 99%

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

Palmer

Podeszwa

Wilson

et al. 2021

JCM

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“…In order to improve the precision of bone axis alterations, these procedures have recently been used to reach the desired outcome [ 20 ]. Therefore, easy-to-handle tools, such as customized cutting guides, could help surgeons to increase the precision of a surgical procedure [ 21 ]. Cutting guides are easy to place and generally ensure unequivocal positioning [ 22 ]; custom cutting guides have recently been introduced as a more accurate and efficient methodology for orthopedic surgery [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Heat Sterilization Effects on Polymeric, FDM-Optimized Orthopedic Cutting Guide for Surgical Procedures

Frizziero

Santi

Leon-Cardenas

et al. 2021

JFB

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Improvements in software for image analysis have enabled advances in both medical and engineering industries, including the use of medical analysis tools to recreate internal parts of the human body accurately. A research analysis found that FDM-sourced elements have shown viability for a customized and reliable approach in the orthopedics field. Three-dimensional printing has allowed enhanced accuracy of preoperative planning, leading to reduced surgery times, fewer unnecessary tissue perforations, and fewer healing complications. Furthermore, using custom tools chosen for each procedure has shown the best results. Bone correction-related surgeries require customized cutting guides for a greater outcome. This study aims to assess the biopolymer-based tools for surgical operations and their ability to sustain a regular heat-sterilization cycle without compromising the geometry and fit characteristics for a proper procedure. To achieve this, a DICOM and FDM methodology is proposed for fast prototyping of the cutting guide by means of 3D engineering. A sterilization test was performed on HTPLA, PLA, and nylon polymers. As a result, the unique characteristics within the regular autoclave sterilization process allowed regular supplied PLA to show there were no significant deformations, whilst annealed HTPLA proved this material’s capability of sustaining repeated heat cycles due to its crystallization properties. Both of these proved that the sterilization procedures do not compromise the reliability of the part, nor the safety of the procedure. Therefore, prototypes made with a similar process as this proposal could be safely used in actual surgery practices, while nylon performed poorly because of its hygroscopic properties.

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“…[12][13][14][15][16] Single-cut osteotomies are also described in the human literature, mainly for treating fracture malunion. [17][18][19][20][21][22][23] A single-cut osteotomy is performed in the plane of maximal deformity, and correction is subsequently achieved by rotation and potentially translation of the opposing bone surfaces. The single-cut osteotomy's main advantage is the increased bone contact, which facilitates a stable fixation and accelerates bone healing.…”

Section: Introductionmentioning

confidence: 99%

Single‐cut osteotomy for correction of a complex multiplanar deformity of the radius in a Shetland pony foal

et al. 2021

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To describe the surgical correction of a multiplanar deformity of the radius in a pony using a single-cut osteotomy. Study design: Case report.Animals: A 9-week-old male Shetland pony foal with a bodyweight of 47 kg. Methods:The foal presented with a complex multiplanar deformity of the right radius. A 3-dimensional model of the bone was created based on computed tomography (CT) imaging. To correct the deformity, the cutting plane for a single-cut osteotomy was calculated following the mathematical approach described by Sangeorzan et al. After osteotomy, the bone was realigned and stabilized with two 4.5 locking compression plates (LCPs).Results: Recovery from surgery was uneventful, and the foal remained comfortable. A CT exam 15 weeks after surgery revealed that diaphyseal deformities improved substantially in procurvatum (from 8 to 1 ), varus (from 27 to 0 ), and rotation (30 to 5 ). The operated radius was 2.1 cm shorter than the left. Eighteenmonth follow up confirmed a functionally and cosmetically acceptable outcome. Conclusion:The single-cut osteotomy resulted in the successful correction of a multiplanar equine long-bone deformity with a favorable outcome in a Shetland pony.Clinical significance: Single-cut osteotomy is an alternative surgical technique for the correction of complex diaphyseal long-bone equine deformities.Computed tomography data and the possibility of printing 3D models provides a significant advantage for rehearsing the procedure and for evaluating the correction that was achieved.

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Single cut distal femoral osteotomy for correction of femoral torsion and valgus malformity in patellofemoral malalignment - proof of application of new trigonometrical calculations and 3D-printed cutting guides

Cited by 27 publications

References 38 publications

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

Heat Sterilization Effects on Polymeric, FDM-Optimized Orthopedic Cutting Guide for Surgical Procedures

Single‐cut osteotomy for correction of a complex multiplanar deformity of the radius in a Shetland pony foal

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