Osteotomy Guides Created Through 3D Tomographic Model for Talus Osteotomies in Massive Allograft Technology Presentation for Massive Fresh Talus Allograft Transplant

Abstract

The use of 3-dimensional (D) printing in the medical segment has been increasing. In cases in which osteotomies are necessary, the use of tomographic reconstruction is useful for their planning. And if we were to add the design of osteotomy guides and 3D printing, we can ensure more precise cuts. This study aims to present 3D printing for the creation of more precise osteotomy guides, in the treatment of massive talus osteochondral lesions; and proving its use in the transplant of fresh osteochondral allografts. We present the planning and the surgery performed on a patient, using this 3D printing method with specific osteotomy guides designed for the massive osteochondral defect in zones 1, 4, and 5 (Raikin) with 2570 mm3 volume and symptomatic. At 3 months and 1 year postoperation it was evaluated with a computerized axial tomography scan, objectifying a good articular reduction and congruence of the allograft without its collapse. Planning with 3D digital design, as it is the design and production of specific surgical tools for this surgery, improved surgical time, achieving the correct fit of the allograft, and allowed for a full coverage of the osteochondral defect. Level of Evidence: Diagnostic Level V according to the criteria of the Oxford Centre for Evidence-Based Medicine (CEBM). See Instructions for Authors for a complete description of levels of evidence.