Open wedge high tibial osteotomy using three-dimensional printed models: Experimental analysis using porcine bone.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Surgical Planning

Background:

• Open wedge high tibial osteotomy (HTO) is a surgical procedure to correct knee alignment.
• Accurate pre-operative planning is crucial for successful HTO outcomes.
• Three-dimensional (3D) printing offers a novel approach for creating patient-specific surgical guides.

Purpose of the Study:

• To evaluate the efficacy of 3D printed models in guiding open wedge high tibial osteotomy (HTO) in a porcine model.
• To assess the accuracy of osteotomy and maintenance of the posterior tibial slope using 3D printed models.

Main Methods:

• Computed tomography (CT) images of 10 porcine knees were used to create 3D models.
• A 3D-Slicer program planned the osteotomy line and correction angle.
• A custom 3D printed model was used to perform the open wedge HTO in porcine bone.
• Accuracy of the osteotomy and posterior tibial slope was measured post-operatively.

Main Results:

• The mean mechanical axis line was 61.8±1.5% from the medial tibia, with no significant difference from the planned 62.5%.
• Planned and post-osteotomy wedge angles were similar (11.5±3.2° vs. 11.4±3.3°, P=0.854).
• Posterior tibial slope angles were also consistent pre- and post-osteotomy (11.2±2.2° vs. 11.4±2.5°, P=0.429).

Conclusions:

• 3D printed models can be effectively used for planning and executing open wedge high tibial osteotomy.
• The use of 3D models in porcine bone resulted in accurate osteotomy and preservation of the tibial slope.
• This technology shows promise for improving surgical precision in HTO procedures.