L. Fricke (Berlin, DE)

University Hospital for Orthopedic and Trauma Surgery PMU Salzburg

Presenter Of 1 Presentation

Podium Presentation Osteochondral Grafts

16.2.3 - Can 3D Printed Guides Significantly Improve the Accuracy of Subchondral Bone Plate Alignment in Autologous Osteochondral Transplants

Presentation Topic
Osteochondral Grafts
Date
14.04.2022
Lecture Time
11:33 - 11:42
Room
Potsdam 3
Session Type
Free Papers
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Purpose A key aspect for the success of autologous osteochondral transplantations is the fit of the subchondral bone plate of the transplant to the recipient area. (Baumbach et al., Draenert et al.). Hence, the aim of this study is to find a way to create precise milling templates and to check whether an experienced surgeon can improve his results by using templates in an animal cadaver study.

Methods and Materials

Methods We performed autologous osteochondral transplants of the posterior lateral condyle to the femoral head of the same bone on 50 femoral pig bones. For 25 bones milling templates were created and used in the transplant process. Cone beam CT scans of the bones were taken. The articular surface of the condyle was matched with the femoral head in the Mimics Inprint 3D Software (Materialise, Belgium) (Figure 1). Templates (Figure 2) were printed using a photopolymer jetting system (Formlabs, USA). For transplantation Surgical Diamond Instruments (BoneArtis, Switzerland) were used. Using CT scans, the fit of the subchondral bone plate of the transplant to the surrounding subchondral bone plate was measured at 0°, 90°, 180°, 270° of the transplant cylinder.

3d template.png

transplant:template.png

Results

Results The average gap between the subchondral bone plate of the transplant and the implant site was 0.27mm in the group with milling-templates and 0.73mm in the group without. We performed a t-test, showing that the milling template transplants outperformed the transplant without a template at a 1% significance level (p<0.01). Furthermore, milling templates displayed a 72% lower variance (σ² = 0.086) versus the transplants without a template (σ² = 0.312).

Conclusion

Conclusion The use of 3D printed milling-templates can improve the fit of the subchondral bone plate in autologous osteochondral transplantation and create a more replicable result throughout the series of surgeries, as displayed by the difference in variance.

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