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Patient-specific guides in orthopedic surgery.

Marc-Olivier Gauci1

  • 1Institut Universitaire Locomoteur et du Sport (IULS), CHU de Nice, Unité de Recherche Clinique Côte d'Azur (UCA), Hôpital Pasteur II, 30, voie Romaine, 06000 Nice, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|November 28, 2021
PubMed
Summary

Patient-specific guides (PSGs) enhance surgical precision but require strict adherence to protocols for optimal outcomes. Their clinical superiority is not yet definitively proven across all procedures.

Keywords:
3D printingCAOSPatient-specific guidesPlanningPrecision

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Area of Science:

  • Orthopedic Surgery
  • Surgical Instrumentation
  • Medical Device Design

Background:

  • Patient-specific guides (PSGs) are custom instruments designed to improve surgical precision.
  • While PSGs aim to achieve preoperative planning goals intraoperatively, their clinical superiority remains unproven.
  • The design and implementation of PSGs involve potential error points that surgeons must manage.

Purpose of the Study:

  • To review the current knowledge on patient-specific guides (PSGs) in orthopedic surgery.
  • To assess the application, effectiveness, and benefits of PSGs.
  • To discuss the integration of PSGs into routine surgical practice.

Main Methods:

  • Review of existing literature and expert opinion (Level of Evidence V).
  • Analysis of PSG application in various orthopedic procedures, including spine, knee, shoulder, and hip surgeries.
  • Discussion of organizational, equipment, and economic considerations for PSG implementation.

Main Results:

  • PSG effectiveness in enhancing surgical exactness varies by procedure, showing benefits in spine, knee osteotomies, and bone tumor surgery.
  • PSGs demonstrate potential benefits such as reduced radiation exposure and shorter operating times.
  • PSGs can aid in training junior surgeons for complex procedures.

Conclusions:

  • Patient-specific guides offer potential for improved surgical precision and training but require careful management and validation.
  • Widespread adoption of PSGs necessitates significant changes in surgical workflows, logistics, and economic models.
  • Further research is needed to definitively establish the clinical superiority of PSGs across diverse orthopedic applications.