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Novel customized template designing for patellar resurfacing in total knee arthroplasty
Authors:Ai‐Bing Huang  Yan‐Song Qi  Chang‐Hui Song  Ji‐Ying Zhang  Yong‐Qiang Yang  Jia‐Kuo Yu
Affiliation:1. Institute of Sports Medicine, Peking University Third Hospital, Beijing, China;2. School of Mechanical and Automotive Engineering, South China University of Technology, Guangzhou, China
Abstract:Due to the irregular shape of patella and difficulty in identifying its bony landmarks, it can be a challenge for surgeons to accurately and symmetrically perform patellar resurfacing. Three‐dimensional (3D) models of 20 patellae were generated from computed tomographic images. Using a computer‐assisted preoperative planning technique, customized template designs were developed to guide patellar resurfacing. The patellar models and corresponding templates were produced through rapid prototyping. The accuracy of this technique was assessed after applying the templates on patellar models and cadaver specimens, respectively. Using preoperative planning and predesigned templates, a significant improvement in symmetric patellar resurfacing, with a mean angle of 1.21° mediolateral (ML) obliquity and 1.95° superoinferior (SI) obliquity, was observed compared with the conventional sawguide technique (mean angle of ML and SI was 4.13°, 4.95°, respectively). Additionally, the use of customized templates reproduced the desired preplanned patellar resection. Preoperative planning with 3D imaging and customized templates improved the accuracy of patellar resurfacing in terms of the obliquity and thickness. Clinical Relevance: A novel customized template designed for patellar resectioning will benefit surgeons in performing patellar resurfacing. This technique will provide accurate patellar resurfacing in clinical practice. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1798–1803, 2016.
Keywords:patellar resurfacing  template  rapid prototyping  preoperative planning  computer‐assisted surgery
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