Abstract
Simple SummaryAccurate planning, for corrective surgeries in case of bone cutting, is necessary to obtain a precise coordination of the skeleton and to achieve the owner’s satisfaction. The present experiment displays a simple and cost-effective technique for surgical planning, utilizing a 3-D bone phantom model in a dog with foreleg deformity. 3-D surgical planning for restorative osteotomy is costly and time-consuming because surgeons need to be helped from commercial companies to get 3-D printed bones. However, practitioners can save time and keep the cost to a minimum by utilizing free software and establishing their 3-D printers locally. Surgical planning for the corrective osteotomy of antebrachial growth deformities (AGD) is challenging for several reasons (the nature of the biapical or multiapical conformational abnormalities and lack of a reference value for the specific breed). Pre-operative planning challenges include: a definite description of the position of the center of rotation of angulation (CORA) and proper positioning of the osteotomies applicable to the CORA. In the present study, we demonstrated an accurate and reproducible bone-cutting technique using patient-specific instrumentations (PSI) 3-D technology. The results of the location precision showed that, by using PSIs, the surgeons were able to accurately replicate preoperative resection planning. PSI results also indicate that PSI technology provides a smaller standard deviation than the freehand method. PSI technology performed in the distal radial angular deformity may provide good cutting accuracy. In conclusion, the PSI technology may improve bone-cutting accuracy during corrective osteotomy by providing clinically acceptable margins.
Highlights
Since the three-dimensional (3-D) fabrication methods developed in 1981 [1,2], this additive manufacturing technology has become possible through the stereo lithography apparatus (SLA) methodAnimals 2020, 10, 1445; doi:10.3390/ani10091445 www.mdpi.com/journal/animals and fused deposition modeling (FDM) 3-D printing process [3]
The simulated bones consisted of the forelimb angular deformity model in a 14-month-old, female Golden Retriever dog weighing 28.4 kg presented with less weight-bearing on the lower left forelimb, restricted flexion and pronation/supination, radial shortening due to premature closure of the epiphyseal growth plates, and pain due to kinetic chain dysfunction (Figure 1a,b)
The proper position of the cut planes and the obtained surgical were subjected to notable differences regarding the average and confidence interval (CI)
Summary
Since the three-dimensional (3-D) fabrication methods developed in 1981 [1,2], this additive manufacturing technology has become possible through the stereo lithography apparatus (SLA) methodAnimals 2020, 10, 1445; doi:10.3390/ani10091445 www.mdpi.com/journal/animals (in 1984) and fused deposition modeling (FDM) 3-D printing process (in 1988) [3]. In 1992, human body cleft palate was produced using 3-D printing by the SLA method. In 1997, a 3-D printed physical model of a human patient’s joint was used to establish a surgical plan in orthopedic surgery and to improve surgical completion [4]. An unfitted osteotomy can lead to serious iatrogenic translation because of inadequately measured bone deformities [5,6]. In the case of angular limb deformity (ALD) corrective osteotomy, many studies have been conducted using the 3-D technique and RP bone model. The improvement of the operation time, irradiation time, surgical invasion, surgical accuracy, and patient pain, patient-specific instrumentations’ (PSI) usefulness—such as risk, pre-operative planning, and surgical error reduction—have recently been demonstrated [7,8,9,10,11,12,13,14,15,16,17]
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