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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 26, Issue 12, pp 3601–3605 | Cite as

Three-dimensional printing improves osteochondral allograft placement in complex cases

  • Kelechi R. Okoroha
  • Timothy J. Evans
  • Jeffrey P. Stephens
  • Eric C. Makhni
  • Vasilios Moutzouros
Knee
  • 202 Downloads

Abstract

The use of three-dimensional (3D) printing has seen a vast expansion over recent years, with an increased application for its use in orthopaedics. This report details the use of 3D printing technology to aid in the treatment of a medial femoral condyle osteochondral defect in a 26-year-old female who had previously undergone a failed autograft procedure. A preoperative computed tomography scan of the knee and chondral defect was used to generate a 3D printed, one-to-one scale replica of the distal femur. This replica was then used to size a patient-specific allograft plug for the osteochondral transplantation procedure. The patient recovered well, and 1 year postoperatively the allograft was well incorporated into the medial femoral condyle and healed. This report illustrates the advantages of using a 3D printed model to allow for tactile feedback and improved visualization that will allow for improved understanding of complex surgical procedures.

Level of evidence V.

Keywords

3D printing Osteochondral allograft transplantation Osteochondritis dissecans Preoperative planning 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

No authors have any financial disclosures.

Ethical approval

The local institutional review board approved this study (IRB: Henry Ford Hospital, Detroit, MI).

Informed consent

A signed formed consent was obtained from the patient allowing publication of this case report.

References

  1. 1.
    Abdel-Salam A, Eyres KS (1995) Effects of tourniquet during total knee arthroplasty. A prospective randomised study. J Bone Joint Surg Br 77:250–253CrossRefGoogle Scholar
  2. 2.
    Bedi A, Feeley BT, Williams RJ, 3rd (2010) Management of articular cartilage defects of the knee. J Bone Joint Surg Am 92:994–1009CrossRefGoogle Scholar
  3. 3.
    Bellanova L, Paul L, Docquier PL (2013) Surgical guides (patient-specific instruments) for pediatric tibial bone sarcoma resection and allograft reconstruction. Sarcoma 2013:787653Google Scholar
  4. 4.
    Borazjani BH, Chen AC, Bae WC et al (2006) Effect of impact on chondrocyte viability during insertion of human osteochondral grafts. J Bone Joint Surg Am 88:1934–1943PubMedGoogle Scholar
  5. 5.
    Chu CR, Convery FR, Akeson WH, Meyers M, Amiel D (1999) Articular cartilage transplantation. Clinical results in the knee. Clin Orthop Relat Res 360:159–168CrossRefGoogle Scholar
  6. 6.
    Emmerson BC, Gortz S, Jamali AA, Chung C, Amiel D, Bugbee WD (2007) Fresh osteochondral allografting in the treatment of osteochondritis dissecans of the femoral condyle. Am J Sports Med 35:907–914CrossRefGoogle Scholar
  7. 7.
    Garrett JC (1994) Fresh osteochondral allografts for treatment of articular defects in osteochondritis dissecans of the lateral femoral condyle in adults. Clin Orthop Relat Res 303:33–37Google Scholar
  8. 8.
    Harris JD, Brophy RH, Siston RA, Flanigan DC (2010) Treatment of chondral defects in the athlete’s knee. Arthroscopy 26:841–852CrossRefGoogle Scholar
  9. 9.
    Hurson C, Tansey A, O’Donnchadha B, Nicholson P, Rice J, McElwain J (2007) Rapid prototyping in the assessment, classification and preoperative planning of acetabular fractures. Injury 38:1158–1162CrossRefGoogle Scholar
  10. 10.
    Jaberi FM (2002) Osteochondritis dissecans of the weight-bearing surface of the medial femoral condyle in adults. Knee 9:201–207CrossRefGoogle Scholar
  11. 11.
    Koh JL, Wirsing K, Lautenschlager E, Zhang LO (2004) The effect of graft height mismatch on contact pressure following osteochondral grafting: a biomechanical study. Am J Sports Med 32:317–320CrossRefGoogle Scholar
  12. 12.
    Lattermann C, Romine SE (2009) Osteochondral allografts: state of the art. Clin Sports Med 28:285–301CrossRefGoogle Scholar
  13. 13.
    Ma L, Zhou Y, Zhu Y et al (2016) 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep 6:23335CrossRefGoogle Scholar
  14. 14.
    Mitsouras D, Liacouras P, Imanzadeh A et al (2015) Medical 3D printing for the radiologist. Radiographics 35:1965–1988CrossRefGoogle Scholar
  15. 15.
    Pallante AL, Chen AC, Ball ST et al (2012) The in vivo performance of osteochondral allografts in the goat is diminished with extended storage and decreased cartilage cellularity. Am J Sports Med 40:1814–1823CrossRefGoogle Scholar
  16. 16.
    Pascual-Garrido C, McNickle AG, Cole BJ (2009) Surgical treatment options for osteochondritis dissecans of the knee. Sports Health 1:326–334CrossRefGoogle Scholar
  17. 17.
    Rengier F, Mehndiratta A, von Tengg-Kobligk H et al (2010) 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg 5:335–341CrossRefGoogle Scholar
  18. 18.
    Sherman SL, Garrity J, Bauer K, Cook J, Stannard J, Bugbee W (2014) Fresh osteochondral allograft transplantation for the knee: current concepts. J Am Acad Orthop Surg 22:121–133PubMedGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Kelechi R. Okoroha
    • 1
  • Timothy J. Evans
    • 1
  • Jeffrey P. Stephens
    • 2
  • Eric C. Makhni
    • 3
  • Vasilios Moutzouros
    • 3
  1. 1.Department of Orthopaedic Surgery, Henry Ford Health SystemHenry Ford HospitalDetroitUSA
  2. 2.School of MedicineWayne State UniversityDetroitUSA
  3. 3.Division of Sports Medicine, Department of Orthopaedic SurgeryHenry Ford HospitalDetroitUSA

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