Application of patient-specific surgical guides in foot and ankle surgery

Three-dimensional printing has rapidly evolved into an important technology in orthopedic surgery, enabling the creation of patient-spe cific instruments, implants, and anatomical models. As printing has become more affordable and accessible, point-of-care manufacturing has increasingly allowed clinicians to design and produce surgical aids directly within clinical units. This development, combined with advances in computed tomography (CT)-based imaging and segmentation software, has significantly expanded the use of patient-specific surgical guides (PSGs), particularly in foot and ankle surgery, where complex multiplanar deformities, poor soft-tissue, and limited visu alization often create technical challenges. Patient-specific surgical guides are generated from thin-slice CT data and allow surgeons to accurately transfer preoperative planning to the operative field. Their use has been reported across a wide range of procedures, including deformity correction, joint fusion, ankle arthroplasty, etc. Across these applications, studies consistently demonstrate improved osteot omy accuracy, enhanced deformity correction, reduced operative time, lower fluoroscopy exposure, and greater reproducibility between surgeons. The increasing adoption of weight-bearing CT has further strengthened the accuracy of preoperative planning by capturing true functional alignment. Despite these advantages, several limitations persist, including increased preoperative imaging requirements, higher initial costs, and dependency on manufacturing logistics. Most published studies remain level III-IV, with limited long-term data on clinical outcomes and cost-effectiveness. Nevertheless, as technological capabilities improve and workflows become more efficient, PSGs are poised to become an integral component of personalized foot and ankle surgery, with the potential to enhance both surgical precision and patient outcomes.   Cite this article as: Kavak S, Ozturk B, Ogut T, DiGiovanni CW, Esfahani SA, Karaismailoglu B. Application of patient-specific surgical guides in foot and ankle surgery. Acta Orthop Traumatol Turc., 2025;59(6):340-348.