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. 2024 Apr 2;10(1):10.
doi: 10.1186/s41205-024-00208-z.

Fabricating patient-specific 3D printed drill guides to treat femoral head avascular necrosis

Cameron Bell  1   2 , Alborz Feizi  3   4 , Gregory R Roytman  3   4 , Alim F Ramji  3 , Steven M Tommasini  3   4 , Daniel H Wiznia  3   4
Affiliations

Fabricating patient-specific 3D printed drill guides to treat femoral head avascular necrosis

Cameron Bell et al. 3D Print Med. .

Abstract

Background: Femoral head avascular necrosis (AVN), or death of femoral head tissue due to a lack of blood supply, is a leading cause of total hip replacement for non-geriatric patients. Core decompression (CD) is an effective treatment to re-establish blood flow for patients with AVN. Techniques aimed at improving its efficacy are an area of active research. We propose the use of 3D printed drill guides to accurately guide therapeutic devices for CD.

Methods: Using femur sawbones, image processing software, and 3D modeling software, we created a custom-built device with pre-determined drill trajectories and tested the feasibility of the 3D printed drill guides for CD. A fellowship trained orthopedic surgeon used the drill guide to position an 8 ga, 230 mm long decompression device in the three synthetic femurs. CT scans were taken of the sawbones with the drill guide and decompression device. CT scans were processed in the 3D modeling software. Descriptive statistics measuring the angular and needle-tip deviation were compared to the original virtually planned model.

Results: Compared to the original 3D model, the trials had a mean displacement of 1.440 ± 1.03 mm and a mean angle deviation of 1.093 ± 0.749º.

Conclusions: The drill guides were demonstrated to accurately guide the decompression device along its predetermined drill trajectory. Accuracy was assessed by comparing values to literature-reported values and considered AVN lesion size. This study demonstrates the potential use of 3D printing technology to improve the efficacy of CD techniques.

Keywords: 3D Printing; Computer-aided design; Femur Head Necrosis; Osteonecrosis; Stereolithography; Surgical Decompression.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The first iteration of the prototype device imaged in ScanIP image processing software
Fig. 2
Fig. 2
(A) 3D-printed guide fitted to a foam cortical shell femur is displayed. The femur was modeled using a dual-energy CT scan and the custom device was fitted using 3D modeling software. A Jamshidi needle, utilized subsequently for an AVN decompression device, was positioned using the modeled femur. A second dual-energy CT-scan was obtained after drilling the foam cortical shell femur with the Jamshidi needle. (B and C) The position of the Jamshidi needle after drilling was compared to the 3D-modeled position
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