Comparison between Novice and Experienced Surgeons Performing Corrective Osteotomy with Patient-Specific Guides in Dogs Based on Resulting Position Accuracy

Abstract

Corrective osteotomy has been applied to realign and stabilize the bones of dogs with lameness. However, corrective osteotomy for angular deformities requires substantial surgical experience for planning and performing accurate osteotomy. Three-dimensional printed patient-specific guides (3D-PSGs) were developed to overcome perioperative difficulties. In addition, novices can easily use these guides for performing accurate corrective osteotomy. We compared the postoperative results of corrective osteotomy accuracy when using 3D-PSGs in dogs between novice and experienced surgeons. We included eight dogs who underwent corrective osteotomy: three angular deformities of the radius and ulna, three distal femoral osteotomies, one center of rotational angle-based leveling osteotomy, and one corrective osteotomy with stifle arthrodesis. All processes, including 3D bone modeling, production of PSGs, and rehearsal surgery were carried out with computer-aided design software and a 3D-printed bone model. Pre- and postoperative positions following 3D reconstruction were evaluated by radiographs using the 2D/3D registration technique. All patients showed clinical improvement with satisfactory alignment and position. Postoperative accuracy evaluation revealed no significant difference between novice and experienced surgeons. PSGs are thought to be useful for novice surgeons to accurately perform corrective osteotomy in dogs without complications.

Clinical applications and prospects of 3D printing guide templates in orthopaedics

“… Year Authors Journal Case number Research type Type of surgery Results 2021 Rho YH et al. [ 127 ] Vet Sci 8 dog A cutting guide and reduction guide for corrective osteotomy It is useful for novice surgeons to accurately perform corrective osteotomy in dogs without complications. 2021 Caiti G et al.…”

“…The template-guided MIPPO group was found to have greater surgical accuracy, with less variation in femoral length, anatomical lateral distal femoral angle (aLDFA), anatomical posterior distal femoral angle (aPDFA), and anteversion angle, with neater alignment and more significant advantages. In addition, the assistance of the guide can reduce the gap between novice and experienced surgeons [ 127 ].…”

Accuracy of Lumbosacral Pedicle Screw Placement in Dogs: A Novel 3D Printed Patient-Specific Drill Guide versus Freehand Technique in Novice and Expert Surgeons

“…As in our study, results of these studies showed that there was no significant difference between the novice and expert surgeon. 20,21 It is interesting to note that besides our study, only one study has compared lumbosacral pedicle screw placement with use of the 3D-PSG and the freehand technique. 10 This study found no difference between rates of medial pedicle wall perforation and based on their results, the study group was unable to recommend the use of 3D-PSG to help increase accuracy.…”

Pelvic Endoprosthesis after Hemipelvectomy Using a 3D-Printed Osteotomy Guide for Infiltrative Osteoma in a Cat

“…It is unlikely that the tumor grew aggressively, or that an error in the process of producing guides and prostheses occurred, because there was no problem in the contact of the resection guide and endoprosthesis. It is possible that errors occurred in the process of identifying tumor invasion into the bone, including the transformation of the DICOM files and the identification of the tumor in the 3D program [ 25 ]. Moreover, CT should be acquired with a slice thickness of 0.5 mm or less to accurately specify the location and size of tumors.…”