3D-printed patient specific surgical guides: Balancing accuracy with practicality

Abstract

IntroductionThree-dimensional (3D) printing technology has been used in orthopaedic surgery in recent years to manufacture customized surgical cutting jigs. However, there is scarcity of literature and information regarding the optimal parameters of an ideal jig. Our study aims to determine the optimum parameters to design surgical jigs that can produce accurate cuts, and remain practical for use, to serve as a guide for jig creation in future. Methods and materialsA biomechanical lab study was designed to investigate whether the thickness of a jig and the height of its cutting slot can significantly affect cutting accuracy. Surgical jigs were 3D printed in medical grade, and an oscillating sawblade was used to mimic intraoperative surgical cuts through the cutting slots onto wooden blocks, which were then analysed to determine the accuracy of cuts. ResultsStatistical analysis was performed on a total of 72 cuts. The cutting accuracy increased when the thickness of the jig increased, at all slot heights. The cutting accuracy also increased as the slot height decreased, at all jig thicknesses. Overall, the parameters for jig construction that yielded the most accurate cuts were a jig thickness of 15 mm, in combination with a slot height of 100 % of the width of the sawblade. Additionally, at a jig thickness of 15 mm, there was no statistically significant difference in cutting accuracy when increasing the slot height to 120 %. ConclusionThis study is the first to propose tangible parameters that can be applied to surgical jig construction to obtain reproducible accurate cuts. Provided that a jig of 15 mm thickness can be accommodated by the size of the wound, the ideal surgical jig with a superior balance of accuracy and useability is 15 mm thick, with a cutting slot height of 120 % of the sawblade thickness.