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Proximal Femoral Valgus Derotation Osteotomy: A Case Study

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PARTNER

Type of work

Precision surgery

technology

3D Printing

Advanced Simulation

Advanced Visualization

Overview

From Challenge to Clarity – 3D Solutions for Complex Clavicle Osteotomies

Coxa vara is a rare hip deformity characterized by a decreased femoral neck-shaft angle. Proximal femoral osteotomy is a surgical procedure used to correct coxa vara, but can be associated with complications. 3D Printing and 3D Virtualization Technologies are increasingly being used in proximal femoral osteotomy procedures, and the integration of these technologies into proximal femoral osteotomies have been shown to provide a number of benefits. The objective of this report is to incorporate 3D virtualization and 3D printing technologies into a proximal femoral osteotomy workflow and evaluate its potential benefits.

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Methods & Results

Precision Without the Guesswork – Reduced Exposure, Enhanced Control

A 13 year old patient with bilateral coxa vara underwent a proximal femoral osteotomy that included virtual surgical planning and 3D printed patient-specific guides. Detailed anatomical modeling and advanced surgical planning processes were employed to create surgical simulations and patient-specific cutting guides. Various clinical parameters were documented, including the duration of the procedure and the patient's vital signs on the day of surgery. The costs associated with 3D Printing and 3D Virtualization Technologies, and the surgery were calculated based on both labour and operating costs. Post-surgical evaluation included a survey with the lead surgeon reflecting on the impact of the 3D solutions used on implementation, communication, accuracy, efficiency, patient outcomes, and satisfaction.

Procedural time was 250 minutes. The surgeon reported that the 3D solutions shortened operating time, improved accuracy in achieving the desired Hip Shaft Angle correction and plate positioning, and increased overall confidence during the procedure. The models were shared with the patient and family, the clinical care team, and trainees, significantly enhancing their understanding of the disease, proposed surgery, as well as potential complications. The 3D solutions also improved consensus among the clinical care team regarding the treatment plan. Procedural time was significantly reduced, despite a slight increase in preoperative planning time. Additionally, the 3D solutions led to a significant reduction in fluoroscopy and radiation exposure. The surgeon was highly satisfied with the 3D solutions, citing their value in enabling the simulation of various angular corrections, predefining screw quantities and lengths, and improving inventory management. The ability to manipulate the virtual model in the operating room and take live measurements was identified as a key advantage. The total cost of implementing 3D solutions was CAD $3,806.21. 3D printed material costs were $868.00 and labour costs were $3,806.21. Total operating room costs were CAD $19,743.94. Operating room personnel costs were CAD $3,518.94 and operating room operating costs were CAD $16,225.00

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Potential Impact

Shaping the Future of Surgery – 3D Planning That Performs

The integration of 3D printing solutions into a proximal femoral osteotomy surgical workflow demonstrated significant procedural and clinical benefits, including improved Hip Shaft Angle correction accuracy, optimized plate positioning and enhanced surgical confidence. The 3D-printed models facilitated better team consensus, improved preoperative planning, and reduced intraoperative time, fluoroscopy use, and radiation exposure. While further research is required to assess long-term patient outcomes, broader applicability, and comprehensive cost implications, these findings highlight the potential of 3D virtualization and 3D printing technologies to enhance surgical efficiency and patient care, supporting its integration into routine workflows.

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