scholarly journals Accuracy of an automated three-dimensional technique for the computation of femoral angles in dogs

2019 ◽  
Vol 185 (14) ◽  
pp. 443-443 ◽  
Author(s):  
Federico Longo ◽  
Gianpaolo Savio ◽  
Barbara Contiero ◽  
Roberto Meneghello ◽  
Gianmaria Concheri ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Patient Specific ◽  
3D Scanner ◽  
Measurement Variability ◽  
Reliable Technique ◽  
Gold Standard Method ◽  
Femoral Torsion ◽  
Custom Made

Aims: The purpose of the study was to evaluate the accuracy of a three-dimensional (3D) automated technique (computer-aided design (aCAD)) for the measurement of three canine femoral angles: anatomical lateral distal femoral angle (aLDFA), femoral neck angle (FNA) and femoral torsion angle.Methods:Twenty-eight femurs equally divided intotwo groups (normal and abnormal) were obtained from 14 dogs of different conformations (dolicomorphic and chondrodystrophicCT scans and 3D scanner acquisitions were used to create stereolithographic (STL) files , which were run in a CAD platform. Two blinded observers separately performed the measurements using the STL obtained from CT scans (CT aCAD) and 3D scanner (3D aCAD), which was considered the gold standard method. C orrelation coefficients were used to investigate the strength of the relationship between the two measurements.Results: A ccuracy of the aCAD computation was good, being always above the threshold of R2 of greater than 80 per cent for all three angles assessed in both groups. a LDFA and FNA were the most accurate angles (accuracy >90 per cent).Conclusions: The proposed 3D aCAD protocol can be considered a reliable technique to assess femoral angle measurements in canine femur. The developed algorithm automatically calculates the femoral angles in 3D, thus considering the subjective intrinsic femur morphology. The main benefit relies on a fast user-independent computation, which avoids user-related measurement variability. The accuracy of 3D details may be helpful for patellar luxation and femoral bone deformity correction, as well as for the design of patient- specific, custom-made hip prosthesis implants.

scholarly journals An Innovative and Cost-Advantage CAD Solution for Cubitus Varus Surgical Planning in Children

2021 ◽  
Vol 11 (9) ◽  
pp. 4057
Author(s):  
Leonardo Frizziero ◽  
Gian Maria Santi ◽  
Christian Leon-Cardenas ◽  
Giampiero Donnici ◽  
Alfredo Liverani ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Low Cost ◽  
Cost Effective ◽  
Varus Deformity ◽  
Patient Specific ◽  
Cubitus Varus ◽  
Surgical Guide ◽  
Traditional Procedure ◽  
Custom Made ◽  
Patient Specific Instruments

The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.

scholarly journals Early Outcomes of Patient-Specific Modular Cones for Substitution of Methaphysial and Diaphysial Bone Defects in Revision Knee Arthroplasty

2019 ◽  
Vol 25 (2) ◽  
pp. 9-18 ◽  
Author(s):  
A. A. Cherny ◽  
A. N. Kovalenko ◽  
S. S. Bilyk ◽  
A. O. Denisov ◽  
A. V. Kazemirskiy ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Scoring Systems ◽  
Bone Defects ◽  
Patient Specific ◽  
Implant Fixation ◽  
Diaphyseal Bone ◽  
Custom Made ◽  
The Stability ◽  
Valid Solution

The aim of this study was the assessment of early outcomes of patient-specific three-dimensional titanium cones with specified porosity parameters to compensate for extensive metaphysical-diaphyseal bone defects in RTKA.Materials and Methods. Since 2017 till 2019 30 patient-specific titanium cones (12 femoral and 18 tibial) implanted during 26 RTKAS. Clinical outcomes evaluated using KSS, WOMAC and fjS-12 scoring systems on average 10 (2–18) months after surgery. At the same time the stability of implant fixation analyzed using frontal, lateral and axial knee roentgenograms.Results. During all procedures there were no technical difficulties in positioning and implantation of custom-made titanium cones. At the time of preparation of the publication, none of the patients had indications for further surgical intervention, as well as intra- and postoperative complications. Six months after surgery all scores improved significantly: KSS from 23 (2–42, SD 19.96) to 66.5 (62–78, SD 7.68), WOMAC from 59 (56–96, SD 28.31) to 32.25 (19–46, SD 11.76), the index FJS-12 was 29.16 points (0–68.75, SD 30.19). The average scores continued to improve up to 18 months: KSS — 97.5 (88–108, SD 9.14), WOMAC — 16.5 (9–24, SD 6.45), FJS-12 — 45.85 (25–75, SD 22.03). No radiolucent lines were noticed during this period of observation.Conclusion. The original additive technology of designing and producing patient-specific titanium cones for compensation of extensive metaphyseal-diaphyseal bone defects in RTKA is a valid solution at least in the short term. A longer follow-up period is required to assess its medium-and long-term reliability compared to existing alternative surgical solutions.

scholarly journals Innovative Design Methodology for Patient-Specific Short Femoral Stems

Materials ◽  
2022 ◽  
Vol 15 (2) ◽  
pp. 442
Author(s):  
William Solórzano-Requejo ◽  
Carlos Ojeda ◽  
Andrés Díaz Lantada
Keyword(s):  
Computer Aided Design ◽  
Design Methodology ◽  
Patient Specific ◽  
Bone Stock ◽  
Innovative Design ◽  
Hip Prostheses ◽  
Custom Made ◽  
In Silico Studies ◽  
Femoral Stems ◽  
Short Stems

The biomechanical performance of hip prostheses is often suboptimal, which leads to problems such as strain shielding, bone resorption and implant loosening, affecting the long-term viability of these implants for articular repair. Different studies have highlighted the interest of short stems for preserving bone stock and minimizing shielding, hence providing an alternative to conventional hip prostheses with long stems. Such short stems are especially valuable for younger patients, as they may require additional surgical interventions and replacements in the future, for which the preservation of bone stock is fundamental. Arguably, enhanced results may be achieved by combining the benefits of short stems with the possibilities of personalization, which are now empowered by a wise combination of medical images, computer-aided design and engineering resources and automated manufacturing tools. In this study, an innovative design methodology for custom-made short femoral stems is presented. The design process is enhanced through a novel app employing elliptical adjustment for the quasi-automated CAD modeling of personalized short femoral stems. The proposed methodology is validated by completely developing two personalized short femoral stems, which are evaluated by combining in silico studies (finite element method (FEM) simulations), for quantifying their biomechanical performance, and rapid prototyping, for evaluating implantability.

scholarly journals Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals

2020 ◽  
Vol 9 (3) ◽  
pp. 832 ◽  
Author(s):  
Dave Chamo ◽  
Bilal Msallem ◽  
Neha Sharma ◽  
Soheila Aghlmandi ◽  
Christoph Kunz ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Accuracy Assessment ◽  
Three Dimensional ◽  
Production Costs ◽  
Patient Specific ◽  
Patient Specific Implants ◽  
3D Printed ◽  
Cost Efficient ◽  
Craniofacial Implants ◽  
Aided Design

The use of patient-specific implants (PSIs) in craniofacial surgery is often limited due to a lack of expertise and/or production costs. Therefore, a simple and cost-efficient template-based fabrication workflow has been developed to overcome these disadvantages. The aim of this study is to assess the accuracy of PSIs made from their original templates. For a representative cranial defect (CRD) and a temporo-orbital defect (TOD), ten PSIs were made from polymethylmethacrylate (PMMA) using computer-aided design (CAD) and three-dimensional (3D) printing technology. These customized implants were measured and compared with their original 3D printed templates. The implants for the CRD revealed a root mean square (RMS) value ranging from 1.128 to 0.469 mm with a median RMS (Q1 to Q3) of 0.574 (0.528 to 0.701) mm. Those for the TOD revealed an RMS value ranging from 1.079 to 0.630 mm with a median RMS (Q1 to Q3) of 0.843 (0.635 to 0.943) mm. This study demonstrates that a highly precise duplication of PSIs can be achieved using this template-molding workflow. Thus, virtually planned implants can be accurately transferred into haptic PSIs. This workflow appears to offer a sophisticated solution for craniofacial reconstruction and continues to prove itself in daily clinical practice.

scholarly journals Main Clinical Use of Additive Manufacturing (Three-Dimensional Printing) in Finland Restricted to the Head and Neck Area in 2016–2017

2019 ◽  
Vol 109 (2) ◽  
pp. 166-173 ◽  
Author(s):  
A.B.V. Pettersson ◽  
M. Salmi ◽  
P. Vallittu ◽  
W. Serlo ◽  
J. Tuomi ◽  
...  
Keyword(s):  
Additive Manufacturing ◽  
Computer Aided Design ◽  
Three Dimensional ◽  
Patient Specific ◽  
Future Research ◽  
Imaging Data ◽  
University Hospitals ◽  
Three Dimensional Printing ◽  
Dimensional Printing ◽  
Head Area

Background and Aims: Additive manufacturing or three-dimensional printing is a novel production methodology for producing patient-specific models, medical aids, tools, and implants. However, the clinical impact of this technology is unknown. In this study, we sought to characterize the clinical adoption of medical additive manufacturing in Finland in 2016–2017. We focused on non-dental usage at university hospitals. Materials and Methods: A questionnaire containing five questions was sent by email to all operative, radiologic, and oncologic departments of all university hospitals in Finland. Respondents who reported extensive use of medical additive manufacturing were contacted with additional, personalized questions. Results: Of the 115 questionnaires sent, 58 received answers. Of the responders, 41% identified as non-users, including all general/gastrointestinal (GI) and vascular surgeons, urologists, and gynecologists; 23% identified as experimenters or previous users; and 36% identified as heavy users. Usage was concentrated around the head area by various specialties (neurosurgical, craniomaxillofacial, ear, nose and throat diseases (ENT), plastic surgery). Applications included repair of cranial vault defects and malformations, surgical oncology, trauma, and cleft palate reconstruction. Some routine usage was also reported in orthopedics. In addition to these patient-specific uses, we identified several off-the-shelf medical components that were produced by additive manufacturing, while some important patient-specific components were produced by traditional methodologies such as milling. Conclusion: During 2016–2017, medical additive manufacturing in Finland was routinely used at university hospitals for several applications in the head area. Outside of this area, usage was much less common. Future research should include all patient-specific products created by a computer-aided design/manufacture workflow from imaging data, instead of concentrating on the production methodology.

Compact Two Degrees-of-Freedom External Fixator System for Correction of Persistent Clubfoot Deformity

2019 ◽  
Vol 13 (2) ◽  
Author(s):  
Ying Ying Wu ◽  
Anton Plakseychuk ◽  
Kenji Shimada
Keyword(s):  
External Fixator ◽  
Degrees Of Freedom ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Current Method ◽  
Tissue Growth ◽  
Learning Curves ◽  
Patient Specific ◽  
Two Degrees Of Freedom

Bone deformities are often complex three-dimensional (3D) deformities, and correcting them is difficult. To correct persistent clubfoot deformity in adolescents or adults, an external fixator is sometimes used to encourage tissue growth and preserve healthy tissues. However, it is difficult to set up, resulting in long surgeries and steep learning curves for surgeons. It is also bulky and obstructs patient mobility. In this paper, we introduce a new approach of defining clubfoot deformity correction as a six degrees-of-freedom (6DOF) correction, and then reducing it to just two degrees-of-freedom (2DOF) using the axis-angle representation. Therefore, only two physical trajectory joints are needed, which in turn enables a more compact fixator design. A computer planner was developed to minimize the bulk of the external fixator, and to optimize the distraction schedule to avoid overstretching the soft tissues. This reduces the learning curve for surgeons and shortens surgery time. To validate the system, a patient-specific clubfoot simulator was developed, and four experiments were performed on the clubfoot simulator. The accuracy of midfoot correction was 11 mm and 3.5 deg without loading, and 41 mm and 11.7 deg with loading. While the external fixator has to be more rigid to overcome resistance against correction, the surgical system itself was able to achieve accurate correction in less than 2 h. This is an improvement from the current method, which takes 2.5–4.5 h.

scholarly journals CAD/CAM Engineered Patient-Specific Impants as a Reposition Device in Le Fort I and Modified Subcondylar Osteotomies: Case Report of Facial Deformity Correction in Acromegaly

2020 ◽  
Vol 13 (3) ◽  
pp. 226-236
Author(s):  
Juho Suojanen ◽  
Zlatan Hodzic ◽  
Tuula Palotie ◽  
Patricia Stoor
Keyword(s):  
Computer Aided Design ◽  
Medical Condition ◽  
Deformity Correction ◽  
Open Bite ◽  
Patient Specific ◽  
Facial Deformity ◽  
Le Fort ◽  
Patient Specific Implants ◽  
Drill Holes ◽  
Le Fort I

Acromegaly is a medical condition where elevated growth hormone or insulin-like growth factor I levels cause several changes in the craniofacial soft and hard features. We report the correction of facial deformity and posterior open bite with Le Fort I and modified subcondylar osteotomies in a patient affected by acromegaly. Computer-aided design and manufacturing generated saw and drill guides were used to perform osteotomies and segment removal. The placement of the patient-specific implants (PSIs) was guided by predesigned drill holes ensuring the required and planned movement of the jaws and position of the PSIs. After segment removal, the PSIs fitted the predesigned drill holes with high precision and were secured without problems. The planned amount of mandibular and maxillary movement was achieved. The occlusion and osteotomies remained stable for the follow-up of 22 months. The use of PSIs combined with guided surgery can be beneficial for selected cases with asymmetry or posterior open bite enabling new approaches and yielding good functional and aesthetic outcome. The modification of conventional ramus osteotomy combined with utilization of ramus segment removal and the use of PSI for reposition is an interesting and promising technique for rare conditions with ramus height asymmetry.

scholarly journals Low cost digital fabrication approach for thumb orthoses

2017 ◽  
Vol 23 (6) ◽  
pp. 1020-1031 ◽  
Author(s):  
Miguel Fernandez-Vicente ◽  
Ana Escario Chust ◽  
Andres Conejero
Keyword(s):  
3D Printing ◽  
Computer Aided Design ◽  
Low Cost ◽  
Three Dimensional ◽  
Recovery Process ◽  
Digital Fabrication ◽  
Cost Comparison ◽  
Content Type ◽  
Custom Made ◽  
The Impact

Purpose The purpose of this paper is to describe a novel design workflow for the digital fabrication of custom-made orthoses (CMIO). It is intended to provide an easier process for clinical practitioners and orthotic technicians alike. It further functions to reduce the dependency of the operators’ abilities and skills. Design/methodology/approach The technical assessment covers low-cost three-dimensional (3D) scanning, free computer-aided design (CAD) software, and desktop 3D printing and acetone vapour finishing. To analyse its viability, a cost comparison was carried out between the proposed workflow and the traditional CMIO manufacture method. Findings The results show that the proposed workflow is a technically feasible and cost-effective solution to improve upon the traditional process of design and manufacture of custom-made static trapeziometacarpal (TMC) orthoses. Further studies are needed for ensuring a clinically feasible approach and for estimating the efficacy of the method for the recovery process in patients. Social implications The feasibility of the process increases the impact of the study, as the great accessibility to this type of 3D printers makes the digital fabrication method easier to be adopted by operators. Originality/value Although some research has been conducted on digital fabrication of CMIO, few studies have investigated the use of desktop 3D printing in any systematic way. This study provides a first step in the exploration of a new design workflow using low-cost digital fabrication tools combined with non-manual finishing.

Use of Three-dimensional Printing and Patient-matched Implant in Total Hip Arthroplasty – a Case Study

2019 ◽  
Vol 21 (3) ◽  
pp. 207-216 ◽  
Author(s):  
Piotr Sypień ◽  
Paweł Łęgosz ◽  
Paweł Małdyk
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Revision Arthroplasty ◽  
Patient Specific ◽  
Oral Antibiotic ◽  
Precise Position ◽  
Total Hip ◽  
Custom Made ◽  
History Of

We present a case report of a 70-year-old female patient with a history of right hip dysplasia and total hip arthroplasty complicated by chronic periprosthetic hipction. Failure of oral antibiotic treatment was an indication for implant removal. A computed tomography scan performed during qualification for reimplantation revealed massive bone defects in the pelvis. A three-dimensional printed patient-specific anatomical model of the pelvis helped to determine the precise position and cup size in preoperative planning and prepare a patient-matched acetabulum. The custom-made endoprosthesis was implanted during revision arthroplasty.

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