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. 2024 Nov 20;16(11):e74112.
doi: 10.7759/cureus.74112. eCollection 2024 Nov.

3D-Printable Knee Arthrometer: Development and Validation

Edmar Stieven Filho  1 , Carolline P Nunes  2 , Ayrton A Martins Neto  1 , Isabela P Nascimento  3 , Jose A Foggiatto  4 , Fernando M Rosa  5 , Paul A Milcent  5 , Caue O Maia  1 , Maisa S Namba  6 , Lucas Santiago  7
Affiliations

3D-Printable Knee Arthrometer: Development and Validation

Edmar Stieven Filho et al. Cureus. .

Abstract

Introduction The anterior cruciate ligament is the most commonly injured ligament in the knee. Its injury is often evaluated with orthopedic tests during physical examination, but this turns out to be a subjective assessment. A knee arthrometer is a mechanical device developed in the 1970s to improve the diagnostic accuracy of anterior cruciate ligament injury. However, due to the high cost and low availability of the devices, they are rarely used in clinical practice and training. In this scenario, the objective of this study was to develop and validate a knee arthrometer to be fabricated by additive manufacturing (3D printing), thus creating a device that is easily accessible to all. Methods This experimental cross-sectional study involved the Orthopedic Skills Laboratory, Department of Surgery, at the Federal University of Paraná and 3D Printing Laboratory of the Professor Leide Parolin Marinoni Simulation Center of Parana Clinical Hospital, in partnership with the Engineering Department at the Federal University of Technology - Paraná, Brazil. Additionally, face validity was conducted at the Workers' Hospital and Parana Clinical Hospital. Ten orthopedic professionals with experience in the use of arthrometers were invited to assemble, evaluate the developed equipment, and answer a questionnaire regarding the assembly, appearance, and usability of the 3D arthrometer. Results At the end of the project, the arthrometer was successfully assembled from 3D-printed and unprinted parts, with an approximate cost of US$30 per device. All participants were able to assemble the 3D arthrometer with the instructions provided, and only one participant requested the instructor's assistance once during assembly. Regarding use, all participants were able to perform the arthrometry successfully and without the need for any assistance. Regarding face validity, we obtained a high degree of agreement among participants regarding the ease of assembly, good appearance, ease of use, and practicality of the equipment. Conclusion Using 3D printing technology to fabricate a knee arthrometer is feasible, resulting in an inexpensive and accessible tool.

Keywords: additive manufacturing; anterior cruciate ligament (acl); anterior cruciate ligament tear; arthrometer; ‎3d printing.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Comitê de Ética do Hospital do Trabalhador - Curitiba (Paraná) - Brasil issued approval 6.944.989. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Scheme of parts and materials for assembling the 3D arthrometer.
1 - main bar (printed); 2 - proximal curve(printed); 3 - proximal arch (printed); 4 - distal curve (printed); 5 - distal arch (printed); 6 - caliper; 7 - left cover (printed); 8 - right cover (printed); 9 - M4 screw; 10 - butterfly M6 screw; 11 - M3 screw; 12 - M4 nut; 13 - M6 nut. Source: [12]
Figure 2
Figure 2. Assembling the device.
Coupling the distal curve (5) to the distal arch (4), and the proximal arch (3) and proximal curve (2), with two M4x16 mm screws (6) and two M4 nuts (7);. Attaching the set, distal arch (4), and distal curve (2), to the main bar (1) of the arthrometer with two M4x16 screws (8) and two M4 nuts (9). Source: [12]
Figure 3
Figure 3. Insert an M6 nut (3) into the pre-countered hole of the proximal angle bracket (2), then tighten an M6x25 knurled thumb screw (4) from bottom to top to secure this section to the main bar (1).
Source: [12]
Figure 4
Figure 4. Insert the digital caliper (2) into the designated hole on the main bar's upper surface (1). Secure it with two nylon cable ties passed through pre-drilled holes (set in red), looping around the caliper jaws to fix it in place.
Source: [12]
Figure 5
Figure 5. Fitting the caliper covers.
To install the caliper cover, fit the cover pieces (3) around the caliper (2), below the main bar (1). To secure the cover in place use two M3 screws (4) and M3 nuts (5). Source: [12]
Figure 6
Figure 6. Arthrometer completely assembled and ready for use.
Source: [12]
Figure 7
Figure 7. Graph with the questions and respective percentages of each answer.
See this image and copyright information in PMC

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