Optimizing the Eden-Hybinette Procedure With 3D-Printed Patient-Specific Instrumentation: A Technical Note

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Recurrent anterior shoulder instability with significant glenoid bone loss often requires complex reconstructive procedures.
• The Eden-Hybinette procedure, utilizing an iliac crest bone graft, is indicated for severe cases, including coracoid dysplasia or failed prior stabilization.
• Traditional methods face challenges in precise graft harvesting and positioning, potentially impacting outcomes.

Purpose of the Study:

• To describe an enhanced open Eden-Hybinette technique using 3D-printed patient-specific cutting guides and a dedicated positioning device.
• To evaluate the accuracy, reproducibility, and safety of this novel approach for shoulder stabilization.

Main Methods:

• Preoperative CT scans were used for detailed planning, including glenoid bone loss assessment and graft dimension calculation.
• A 3D-printed patient-specific guide facilitated reproducible tricortical iliac crest graft harvesting.
• A dedicated positioning device (HyLa) ensured accurate intraoperative graft placement, preventing overhang or medialization.

Main Results:

• Patient-specific instrumentation enabled precise graft sizing and accurate placement.
• Postoperative imaging confirmed excellent graft congruency and stable fixation.
• Patients achieved functional recovery within six months, reporting no recurrence of instability or donor-site morbidity.

Conclusions:

• Combining 3D-printed guides with specialized instrumentation offers significant advantages for the Eden-Hybinette procedure in revision shoulder stabilization.
• This technique improves accuracy, reproducibility, and safety by anticipating graft parameters and screw trajectories.
• Further clinical validation is needed to compare outcomes against conventional methods.