Three-Dimensional Printed Patient Specific Guides for Acute Correction of Deformities

Carradine, Darren R et al. “Three-Dimensional-Printed Patient-Specific Osteotomy Guides, Repositioning Guides and Titanium Plates for Acute Correction of Antebrachial Limb Deformities in Dogs.” Veterinary and comparative orthopaedics and traumatology : Vet Comp Orthop Trauma vol. 34,1 (2021): 43-52.

Key Point: 3D-printed surgery guides facilitate accurate acute correction of antebrachial deformities in this case series, and simplifies intraoperative surgical decision-making on limb position with good clinical outcomes.

Thanks to three-dimensional (3D) printing technology, 3D printed products have been used for many purposes in veterinary medicine in recent years. It can be used in many stages like training in veterinary surgery, informing the owner before the operation, surgery planning, prosthesis, or orthosis production. The fact that the patient-specific model can be produced with 3D printing and its similarity to reality, the economic and minimal microbial risk makes 3D models attractive.

Apart from these basic applications, advanced surgical planning and rehearsal procedures, production and intraoperative use of patient-specific drilling and cutting guides, production of patient-specific implants and various biomaterials, and other applications that have been studied have effective advantages in increasing the success of treatment. In cases where the surgical method requires a complex series of procedures and the area to be operated includes complex and intricate structures, the success of the surgery is increased by performing advanced surgical planning with 3D printing products. A common surgical scenario is a limb deformity, which may have both angular and torsional components. These surgeries are difficult to plan off of digital radiography, and leave room for iatrogenic error peri-operatively. Thanks to this 3D technology we can perform surgical rehearsal that in turn may shorten the operation and anesthesia time and reduce the possibility of iatrogenic damage/error in the surgical procedure. 

In recent years, peer-reviewed literature is growing exponentially. Dr. Carwardine and colleagues (VCOT 2021) evaluated clinical utility of these patient specific surgical guides in a short case series of complex limb deformity cases. They found that all (n = 4) limbs were corrected to within 3.5-7.5 degrees of the pre-planned deformity correction. This same team also produced patient specific 3D printed titanium plates for all cases, and no complications were found with nearly 2-year follow-up. The author noted that 3D-printed surgical guides and titanium plates facilitated the accurate acute correction of antebrachial deformities in this case series. The methodology described simplifies intraoperative surgical decision-making on limb position with good clinical outcomes seen in a small number of clinical cases.

For more information on how this technology is impacting how we approach angular limb deformity cases, utilize 3D models, and use patient-specific technology click here (https://www.arizonacanineorthopedics.com/3-dimensional-patient-specific-planning-and-modeling.html).

Brian Petrovsky, DVM

Diplomate, American College of Veterinary Surgeons (Small Animal)