ArticleInternational orthopaedics2025
Three dimensional printing patient specific cutting guides for Pes cavus midfoot osteotomy-a retrospective cohort comparative study.
Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis comparative cohort study evaluates the clinical efficacy of 3D-printed patient-specific cutting guides (PSCGs) versus conventional manual techniques in correcting rigid midfoot pes cavus deformities.
methodsA retrospective analysis of 40 patients (80 feet) undergoing Cole osteotomy between 2021 and 2023 was conducted. Patients were stratified into two matched cohorts: Group A (manual osteotomy, n = 20) and Group B (PSCG-assisted, n = 20). Radiographic parameters (Meary's angle, TMI, TCA, Djian-Annonier angle, Pitch angle) and functional outcomes (VAS, AOFAS, SF-36) were analyzed preoperatively and at mean 17-month follow-up. Surgical metrics including operative time, fluoroscopy frequency, and complication rates were systematically compared.
resultsRadiographic analysis demonstrated superior angular correction in the PSCG-assisted cohort versus conventional osteotomy, with significantly improved bilateral Meary's angle (Right: 1.94°±0.62 vs. 6.04°±2.20, P < 0.05; Left: 1.62°±0.54 vs. 6.39°±2.04, P < 0.05) and TMI angle (Right: 4.32°±3.14 vs. 8.51°±8.12, P < 0.05; Left: 4.74°±2.44 vs. 8.53°±5.93, P < 0.05). The PSCG technique achieved equivalent correction in TCA, Djian-Annonier, and Pitch angles while demonstrating enhanced consistency (38-66% reduction in standard deviations). Functionally, PSCG-assisted procedures yielded superior AOFAS scores (97.71 ± 0.77 vs. 92.07 ± 2.25, Δ = 5.64 [95%CI 4.54-6.74], P < 0.05) and SF-36 outcomes, particularly in general health (Δ = 16.96, P < 0.05) and mental well-being (Δ = 7.92, P = 0.001). Operative metrics favored PSCG with 36% shorter procedure time (82.9 ± 13.9 vs. 129.0 ± 39.6 min, P < 0.05) and 77% reduced intraoperative fluoroscopy (4.65 ± 1.06 vs. 20.07 ± 2.92 exposures, P < 0.05). No surgical site infections occurred in the PSCG group versus one superficial SSI in controls
conclusion3D-printed PSCGs provide anatomically precise, efficient correction of complex midfoot deformities while minimizing intraoperative radiation exposure, establishing this technology as a safe and reproducible alternative to conventional techniques.
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