Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jul-Sep;9(3):254-259.
doi: 10.1016/j.jcot.2018.07.013. Epub 2018 Jul 18.

Computed tomography based 3D printed patient specific blocks for total knee replacement

Raju Vaishya  1 , Vipul Vijay  1 , Abhishek Vaish  2 , Amit K Agarwal  1
Affiliations
Review

Computed tomography based 3D printed patient specific blocks for total knee replacement

Raju Vaishya et al. J Clin Orthop Trauma. 2018 Jul-Sep.

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1169-1171. doi: 10.1016/j.jcot.2020.09.032. Epub 2020 Sep 26. J Clin Orthop Trauma. 2020. PMID: 33013141 Free PMC article.

Abstract

Objectives: 3D printing is an emerging technology and its use in orthopaedics is being explored. We discuss the role of computed tomography based 3D printed patient specific jigs in total knee replacement. We also discuss the various advantages of 3D printed patient specific jigs and the future scope of their use in total knee replacement.

Methods: A search of English literature was done and articles discussing the role of CT scan based 3D printed patient specific jigs in total knee replacement were included in the study.

Results: The role of 3D printed jigs in total knee replacement have been found in the prediction of femoral valgus angle, component sizing and in retained hardware. They have shown promise with studies suggesting they might improve the overall mechanical alignment of the knee. There are studies which have also studied the combined role of patient specific instruments with navigation.

Conclusion: 3D printed jigs hold promise in total knee replacement. Their use in total knee replacement in the presence of retained hardware is useful for the surgeon. They have also showed promise in improving prediction of component sizing and improving mechanical alignment of the knee. Further studies with longer follow up and larger sample size will help in establishing their role in total knee replacement.

Keywords: 3D printing; Arthroplasty; Customized instruments; Patient-specific blocks; Total knee replacement.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The computed tomography based 3D printed jigs used for total knee arthroplasty. The left is the femoral jig matching the anterior distal femoral anatomy and the tibial jigs on the right side matches the proximal anterior tibial anatomy.
Fig. 2
Fig. 2
The femoral patient specific jig depicted intra-operatively matching the distal anterior femoral anatomy and sitting snug on the anterior femoral cortex.
Fig. 3
Fig. 3
The tibial patient specific jig anatomically matching the proximal tibial anatomy and is used to pin the conventional proximal tibial cutting jigs for the cuts.
Fig. 4
Fig. 4
Image depicting the calculation of the mechanical axis, anatomical axis and femoral valgus angle in a virtual 3D model of the patient femur.
Fig. 5
Fig. 5
An illustrative case depicting the sizing of the femoral and tibial components on the 3D reconstructed model of the bones.
Fig. 6
Fig. 6
A case of retained hardware with the presence of a dynamic condylar screw in the distal femur needing total knee arthroplasty. The preoperative planning depicted that the screw was approximately 2 mm away from the position of the pins for the distal femoral jig after preoperative planning. Since, the use of intramedullary rod was not needed and there was no interference with the implants, implant removal was averted and routine total knee arthroplasty was performed.
See this image and copyright information in PMC

References

    1. Vaishya R., Vijay V., Birla V.P., Agarwal A.K. Computerized tomography based “patient specific blocks” improve postoperative mechanical alignment in primary total knee arthroplasty. World J Orthoped. 2016 Jul 18;7(7):426–433. - PMC - PubMed
    1. Zein I., Hutmacher D.W., Tan K.C., Teoh S.H. Fused deposition modeling of novel scaffold architectures for tissue engineering applications. Biomaterials. 2002;23(4):1169–1185. - PubMed
    1. Mahmoud A., Bennett M. Introducing 3-dimensional printing of a human anatomic pathology specimen: potential benefits for undergraduate and postgraduate education and anatomic pathology practice. Arch Pathol Lab Med. 2015;139(8):1048–1051. - PubMed
    1. Deakin A.H., Basanagoudar P.L., Nunag P., Johnston A.T., Sarungi M. Natural distribution of the femoral mechanical-anatomical angle in an osteoarthritic population and its relevance to total knee arthroplasty. Knee. 2012;19(2) 120– 12310.1016/j.knee.2011.02.001. - PubMed
    1. Bardakos N., Cil A., Thompson B. Mechanical axis cannot be restored in total knee arthroplasty with a fixed valgus resection angle: a radiographic study. J Arthroplasty. 2007;22 (6 Suppl. (2)):85–8910.1016/j.arth.2007.04.018. - PubMed

LinkOut - more resources