Three-dimensional-printed custom guides for bipolar coxofemoral osteochondral allograft in dogs

Abstract

The objective of this experimental study was to develop and evaluate a three-dimensionally printed custom surgical guide system for performing bipolar coxofemoral osteochondral allograft transplantation in dogs. Five cadaver dogs, weighing 20–38 kg were used in the study. Custom surgical guides were designed and three-dimensionally printed to facilitate accurate execution of a surgical plan for bipolar coxofemoral osteochondral allograft transplantation. Guide-assisted technique was compared to freehand technique in each cadaver. Surgical time was recorded and postoperative computed tomography and three-dimensional segmentation was performed. Femoral version and inclination angles, femoral neck length, and gap present at the femoral and acetabular donor-recipient interface was compared between the virtual surgical plan and postoperative outcome for both techniques. One-tailed paired t-test (P < .05) was used for statistical analysis. When compared to free-hand preparation, mean donor femoral preparation time was 10 minutes longer and mean recipient preparation time was 2 minutes longer when using guides (p = 0.011 and p = 0.001, respectively). No difference in acetabular preparation time was noted between groups. Gap volume at the acetabular and femoral donor-recipient interface was not different between groups. Mean difference between the planned and postoperative version angle was 6.2° lower for the guide group when compared to the freehand group (p = 0.025). Mean femoral neck length was 2 mm closer to the plan when using guides than when performing surgery freehand (p = 0.037). Accuracy for femoral angle of inclination was not different between groups. Custom surgical guides warrants consideration in developing bipolar coxofemoral osteochondral allograft transplantation as an alternative surgical technique for managing hip disorders in dogs.