Patient-specific 3D-printed ALBA osteotomy guides for oblique tibial tuberosity osteotomy in dogs: An ex vivo study

To design and evaluate patient-specific 3D-printed osteotomy guides for Fulkerson-based oblique novel technique (FONT) and to compare their accuracy and consistency with those achieved using a freehand approach.

Ex-vivo canine model.

Twelve pairs of canine cadaveric tibiae from dogs weighing 10-30 kg.

Within each pair, specimens were randomly assigned to either a Freehand osteotomy group or Osteotomy Guide Group. Pre- and postoperative computed tomography scans were obtained to assess osteotomy angles. Customized guides were designed from CT-based 3D models and manufactured using the polylactic acid filament. Postoperative CT images were used to compare the achieved osteotomy angle with the target angle (30°), and deviations between groups were analyzed using the Wilcoxon signed-rank test.

The 3D-printed osteotomy guide group showed significantly greater accuracy and consistency compared with the freehand group. The mean osteotomy angle was 30.73° ± 1.00° in the guide group and 33.45° ± 5.33° in the freehand group. The mean deviation from the target angle was 0.88° ± 0.86° and 4.97° ± 3.81°, respectively. The use of patient-specific 3D-printed osteotomy guides reduced angular deviation by 4.09°. No guide-related complications or deformations were observed during the procedures.

Under experimental conditions, patient-specific 3D-printed advancement and lateralization-based angulation (ALBA) osteotomy guides significantly improved the accuracy and repeatability of oblique tibial osteotomies in dogs. Their use may support more precise execution of the Fulkerson-based oblique novel technique (FONT), although further in vivo studies are required to confirm their clinical applicability.