Fracka et al: 3D-printed, patient-specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement
Veterinary Surgery 5, 2023

🔍 Key Findings

  • 3D-printed patient-specific guides (PSGs) improved tibial cut alignment in the frontal plane compared to generic guides (mean error 1.03° vs 2.41°, p = .036).
  • All tibial cuts using PSGs were within 3° of target alignment, while 2/8 of the generic group were outliers.
  • PSGs significantly improved sagittal alignment of both distal (p = .018) and cranial (p = .043) femoral cuts.
  • No significant difference was found in varus-valgus femoral alignment or closing angle between PSG and generic guide groups.
  • Tibial sagittal slope alignment was not significantly different between groups.
  • PSGs provided better intraoperative usability, including improved visibility, no loosening, and ease of use.
  • Femoral sizing and component fit were equivalent between PSGs and generic guides, ensuring proper prosthesis alignment.
  • PSGs may offer training advantages for novice surgeons, especially in anatomically complex or deformed joints.

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Fracka et al: 3D-printed, patient-specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement
Veterinary Surgery 5, 2023

🔍 Key Findings

  • 3D-printed patient-specific guides (PSGs) improved tibial cut alignment in the frontal plane compared to generic guides (mean error 1.03° vs 2.41°, p = .036).
  • All tibial cuts using PSGs were within 3° of target alignment, while 2/8 of the generic group were outliers.
  • PSGs significantly improved sagittal alignment of both distal (p = .018) and cranial (p = .043) femoral cuts.
  • No significant difference was found in varus-valgus femoral alignment or closing angle between PSG and generic guide groups.
  • Tibial sagittal slope alignment was not significantly different between groups.
  • PSGs provided better intraoperative usability, including improved visibility, no loosening, and ease of use.
  • Femoral sizing and component fit were equivalent between PSGs and generic guides, ensuring proper prosthesis alignment.
  • PSGs may offer training advantages for novice surgeons, especially in anatomically complex or deformed joints.

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Multiple Choice Questions on this study

In Fracka 2023 et al., on patient-specific guides, what was suggested as a practical benefit of PSGs for veterinary surgeons?

A. They eliminate the need for pre-op imaging
B. They are more cost-effective for low-volume TKR surgeons
C. They improve joint capsule healing
D. They increase implant longevity directly
E. They allow stifle resurfacing

Answer: They are more cost-effective for low-volume TKR surgeons

Explanation: PSGs were proposed as a cost-effective alternative for surgeons doing few TKR cases annually.
In Fracka 2023 et al., on patient-specific guides, which of the following was significantly improved in tibial alignment when using PSGs versus generic guides?

A. Frontal plane alignment
B. Sagittal plane alignment
C. Component rotational placement
D. Tibial keel preparation
E. Femoral component sizing

Answer: Frontal plane alignment

Explanation: PSGs significantly reduced frontal plane alignment error compared to generic guides (p = .036).
In Fracka 2023 et al., on patient-specific guides, what was a notable advantage of PSGs during surgery?

A. Shorter overall surgery time
B. Improved patellar tracking
C. Eliminated the need for cemented implants
D. No intraoperative guide loosening
E. Improved soft tissue balancing

Answer: No intraoperative guide loosening

Explanation: None of the PSGs loosened during surgery, unlike generic guides which may loosen.
In Fracka 2023 et al., on patient-specific guides, what best describes the effect of PSGs on sagittal plane alignment of femoral cuts?

A. No effect on any cuts
B. Significant improvement in cranial cut only
C. Significant improvement in distal cut only
D. Significant improvement in both cranial and distal cuts
E. Improved frontal alignment but not sagittal

Answer: Significant improvement in both cranial and distal cuts

Explanation: PSGs significantly improved sagittal alignment of both distal and cranial femoral cuts (p = .018, p = .043).
In Fracka 2023 et al., on patient-specific guides, what did NOT significantly differ between PSG and generic guide groups?

A. Tibial frontal alignment
B. Femoral sagittal alignment
C. Femoral component locking angle
D. Femoral cranial cut alignment
E. Tibial frontal error variance

Answer: Femoral component locking angle

Explanation: The locking angle was not significantly different between groups (p = .871).

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