Complex Osteotomies of Tibial Plateau Malunions Using Computer-Assisted Planning and Patient-Specific Surgical Guides.
The accurate reduction of tibial plateau malunions can be challenging without guidance. In this work, we report on a novel technique that combines 3-dimensional computer-assisted planning with patient-specific surgical guides for improving reliability and accuracy of complex intraarticular corrective osteotomies. Preoperative planning based on 3-dimensional bone models was performed to simulate fragment mobilization and reduction in 3 cases. Surgical implementation of the preoperative plan using patient-specific cutting and reduction guides was evaluated; benefits and limitations of the approach were identified and discussed. The preliminary results are encouraging and show that complex, intraarticular corrective osteotomies can be accurately performed with this technique. For selective patients with complex malunions around the tibia plateau, this method might be an attractive option, with the potential to facilitate achieving the most accurate correction possible.
*Computer-Assisted Research and Development Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; and †Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Philipp
P
Fürnstahl
Lazaros
L
Vlachopoulos
Andreas
A
Schweizer
Sandro F
SF
Fucentese
Peter P
PP
Koch
D000328:Adult; D003198:Computer Simulation; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008954:Models, Biological; D010027:Osteotomy / Q000379:methods*; D066230:Patient-Specific Modeling; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface