Three-dimensional-printed patient-specific guides for tibial deformity correction in small-breed dogs.

Abstract

To describe the use of patient-specific 3-D-printed osteotomy, reduction, and compression guides for tibial closing wedge osteotomy in small-breed dogs. 6 dogs with unilateral tibial deformities. Six small-breed dogs with 1 or a combination of tibial deformities, including excessive tibial plateau angle, valgus, and torsion, were scheduled to undergo tibial closing wedge osteotomy using patient-specific 3-D-printed osteotomy, reduction, and compression guides. The location and orientation of the wedge osteotomy were determined based on CT data using computer-aided design software. After the tibial deformities were corrected, postoperative CT or radiographs were obtained to compare the achieved tibial limb angles with the planned angles. Clinical evaluation and radiographic follow-up were performed on all dogs. Guides were successfully positioned at each specific location, and osteotomies were performed without radiation exposure or observer assistance in all dogs. Tibial deformities were corrected with angular errors of 1.8 ± 1.4°, 2.3 ± 2.1°, and 2.6 ± 1.3° in the sagittal, frontal, and transverse planes, respectively. Mild complications resolved within 1 month in 3 dogs, and revision surgery was not required. Five dogs improved to the normal gait (mean, 14.8 ± 6.6 weeks), and 1 dog recovered a satisfactory gait 24 weeks after surgery. All limbs healed 14 ± 4.7 weeks after surgery. Patient-specific 3-D-printed osteotomy, reduction, and compression guides can provide effective assistance allowing accurate correction of tibial deformities. Their use yields good clinical outcomes in small-breed dogs.