Patient-Specific 3D-Printed Osteotomy Guides and Titanium Plates for Distal Femoral Deformities in Dogs with Lateral Patellar Luxation

• Published in: Animals (Basel) Vol. 14; no. 6; p. 951
• Main Authors: Panichi, Enrico, Cappellari, Fulvio, Burkhan, Ekaterina, Principato, Gaetano, Currenti, Marco, Tabbì, Marco, Macrì, Francesco
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-03-2024; MDPI
• Subjects: CAD-CAM systems; Case Report; Comparative analysis; complex femoral deformities; Computer programs; Computer-aided design; computer-aided design (CAD); CT imaging; Dexmedetomidine; Dogs; Expected values; lateral patellar luxation; Medical research; Medicine, Experimental; Orthopedics; Osteotomy; patient-specific 3D-printed fixation plate; patient-specific 3D-printed osteotomy guides; Physiological aspects; Planning; Range of motion; Software; Surgeons; Surgical techniques; Titanium; Tomography; Veterinary medicine; virtual surgical planning (VSP); Russia; Italy; distal femoral trapezoid osteotomies (DF-TO); patient-specific 3D-printed fixation plate; computer-aided design (CAD); complex femoral deformities; lateral patellar luxation; virtual surgical planning (VSP); patient-specific 3D-printed osteotomy guides
• ISSN: 2076-2615; 2076-2615
• DOI: 10.3390/ani14060951

The aim of this study was to describe the diagnosis and treatment of grade IV lateral patellar luxation (LPL) in two adult large breed dogs with complex femoral deformities using patient-specific three-dimensionally (3D) printed osteotomy guides and implants. Computed tomography (CT) scans were obtained for virtual surgical planning (VSP) using computer-aided design (CAD) software, which allowed for 3D reconstruction and manipulation of the femoral deformities, providing a preoperative view of the correction. Of the two patients, one was affected bilaterally and the other unilaterally, but both dogs were from the same litter. Therefore, the healthy femur of the unilaterally affected patient was used as the physiological reference for the virtual surgical correction. Three distal femoral trapezoid osteotomies (DF-TO) followed by reduction and internal fixation with plates were performed using patient-specific 3D-printed osteotomy guides and implants. This type of osteotomy permitted correction of procurvatum in all the femurs to increase knee extension, raise the dog's lumbar spine and correct the kyphosis. Preoperative, expected and postoperative femoral angles were compared to evaluate the efficacy of virtual surgical planning and the outcome of surgical correction. Radiographic follow-up, passive range of motion and functional recovery were recorded. There were no major complications requiring revision surgery. Significant clinical improvement was observed in both patients. This study suggests that the treatment used represents a viable surgical alternative to restore limb alignment in patients with complex femoral deformities.