In young active patients who have suffered a rupture of the anterior cruciate ligament (ACL), ACL reconstruction is the cornerstone of treatment. Current techniques are designed to reconstruct the ACL in an anatomic position. Non anatomic placement of the ACL graft leads to increased risk of failure of the graft. Failure of reconstruction occurs in 0-14% of primary ACL reconstructions. In up to 54% of cases, technical failure is an additive cause for failure. In 80% of technical failures, malposition of the femoral tunnel is the issue. Current surgical techniques with universal guides leading the direction for tunnels seem to come short in providing a constant and reliable result for creating a femoral tunnel at the individual anatomic origin of the ACL. The need for a patient specific drill guide for femoral tunnel placement seems apparent.

Purpose

To determine the in vitro accuracy of a patient specific 3D printed surgical guide, to be used for femoral tunnel positioning in ACL reconstruction.

Methods

A patient specific guide for femoral tunnel positioning in ACL reconstruction was created for 4 human cadaveric knee specimens based on both routine clinical MRI and 3D MRI. Molds were created in 100%, 1mm larger and 1 mm smaller than the original. Printing accuracy was assessed. Fitting properties were judged by two orthopaedic surgeons. MRI scanning was performed both pre- and post-procedure. The planned trajectory was compared to the actual drilled trajectory.

Results

High printing accuracy was achieved with a deviation of 0.1-0.3 mm (SD 0.12-0.14mm). Molds based on routine clinical MRI with an enlargement of +1mm were judged to fit best. The patient specific 3D printed guide proved to be very accurate with a deviation of 1.5 mm from the intended tunnel location.

Conclusions

Usage of a patient specific 3D printed surgical guide for femoral tunnel placement in ACL reconstruction seems promising. Using this novel instrument, femoral tunnel placement in ACL reconstruction may become more accurate and consistent, especially in low volume surgeons.

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Outcomes After Repair Of Quadriceps Tendon Rupture In Patients 40 Years Of Age And Younger ePoster Presentation Peters T. Otlans, MD, MPH, UNITED STATES Somnath Rao, BS, UNITED STATES Ashok Para, MD, UNITED STATES Stanley Szeto, BS, UNITED STATES Taylor D'Amore, MD, UNITED STATES Steven B. Cohen, MD, UNITED STATES
Comparison Of Bone Marrow Aspirate Concentrate And Allogenic Human Umbilical Cord Blood Derived Mesenchymal Stem Cell Implantation On Chondral Defect Of Knee: Assessment Of Clinical And Magnetic Resonance Imaging Outcomes At 2-Year Follow-Up ePoster Presentation Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF Myung Ku Kim, MD, KOREA, REPUBLIC OF Yoon Sang Jeon, MD, KOREA, REPUBLIC OF Won Hwan Kwon, MD, KOREA, REPUBLIC OF Yun Moon Jeon, MD, KOREA, REPUBLIC OF Kyeuback Kwon, MD, KOREA, REPUBLIC OF
Arthroscopic tri-pulley Technology reduction and internal fixation of pediatric Tibial Eminence fracture ePoster Presentation

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Patient Specific Instrumentation In Acl Reconstruction. A Novel Technique Using A 3D Printed Guide.

Patient Specific Instrumentation In Acl Reconstruction. A Novel Technique Using A 3D Printed Guide.

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Patient Specific Instrumentation In Acl Reconstruction. A Novel Technique Using A 3D Printed Guide.

Patient Specific Instrumentation In Acl Reconstruction. A Novel Technique Using A 3D Printed Guide.

Background

Purpose

Methods

Results

Conclusions