Is Previously Implanted Osteosynthesis Material an Obstacle for the Use of Customized Guides?: A Case Report.

CASE: We present the case of a 46-year-old patient with asymmetric deformity in the posterior tibial slope after previous high tibial osteotomy surgeries with the presence of a medial osteotomy plate. A customized cutting guide was designed to fit on the plate to perform a single surgery and avoid possible soft-tissue complications after multiple surgeries. CONCLUSIONS: The presence of a previous internal fixation device may affect the manufacture of 3-dimensional cutting guides. However, in this case, the previously placed osteosynthesis plate was used as an aid for creating the guide.

Double Level Osteotomy Assisted by 3D Printing Technology in a Patient with Blount Disease: A Case Report.

CASE: We describe the case of a 26-year-old patient diagnosed with Blount disease. She underwent a medial oblique supracondylar biplanar closing-wedge osteotomy of the distal femur followed by a medial oblique biplanar opening-wedge osteotomy of the proximal tibia. 3D printed cutting guides were used for the procedures. At 18 months after surgery, the patient is pain-free and walks without aids. CONCLUSIONS: Using 3D printed guides allowed for accurate correction of the deformity and reduced the risk of damaging critical structures. These guides could be an appropriate alternative for the surgical treatment of patients with Blount disease.

Internal Hemipelvectomy and Reconstruction Assisted by 3D Printing Technology Using Premade Intraoperative Cutting and Placement Guides in a Patient With Pelvic Sarcoma: A Case Report.

CASE: We describe the case of a 75-year-old patient diagnosed with high-grade epithelioid hemangioendothelioma in the left hemipelvis. She underwent an internal hemipelvectomy, followed by reconstruction with a tumor prosthesis with iliac anchorage using 3D-printed cutting and placement guides. Eighteen months postoperatively, she is pain-free and walks without appliances. CONCLUSIONS: Using 3D-printed guides could be an appropriate alternative for patients with aggressive bone tumors in the pelvic area that require hemipelvectomy and reconstruction using a prosthesis with iliac anchorage. 3D-printed cutting guides allow precise resection with appropriate margins, could reduce the risk of injuring critical structures, and facilitate proper prosthetic component positioning.

Pulsed electromagnetic stimulation of regenerate bone in lengthening procedures.

Distraction osteogenesis for limb lengthening represents the treatment of choice in patients with small stature or limb length discrepancies. Bone lengthening and callus formation requires a long therapy. Pulsed electromagnetic fields (PEMF) are normally used to enhance osteogenesis in patients with non-unions. In this study we investigated whether pulsed electromagnetic fields could be used effectively to encourage callus formation and maturation during limb lengthening procedures. Thirty patients underwent bilateral bone lengthening of the humerus, femur or tibia. At day 10 after surgery, PEMF stimulation was started on one side, for 8 hours/day. Stimulated distraction sites exhibited earlier callus formation and progression, and a higher callus density compared to non-stimulated sites. External fixation could be removed on average one month earlier in PEMF stimulated bones. Our results show that the use of pulsed electromagnetic fields stimulation during limb lengthening allows shortening the time of use of the external fixation.