3D printed aiming device for equine proximal interphalangeal joint arthrodesis: Ex vivo study.
Authors: Aimonetti Emma, Genton Martin, Lischer Christoph Johannes, Rossignol Fabrice
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: 3D-Printed Guidance for Equine PIPJ Arthrodesis Proximal interphalangeal joint arthrodesis remains a technically demanding procedure in equine surgery, particularly regarding accurate transarticular screw placement, which directly influences construct stability and long-term outcome. Researchers compared a custom 3D-printed titanium aiming device against freehand technique in 40 cadaveric forelimbs, with both an experienced surgeon and a trainee performing 10 procedures each using both methods, measuring operative time, radiographic checks required, and screw placement accuracy. For the less experienced surgeon, the aiming device delivered substantial improvements: procedure time fell by 25% (from 27.24 to 20.16 minutes), intraoperative radiographs dropped by 60% (6.1 to 2.1 images), and screw placement accuracy improved by 31%, with construct symmetry increasing 47%. The senior surgeon benefited primarily from reduced imaging requirements (58% fewer radiographs), with no significant gains in speed or precision—suggesting the device most benefits less-experienced practitioners rather than established operators. For equine practitioners seeking to standardise technique and reduce surgical unpredictability, particularly in training environments, this custom-printed guidance system represents a meaningful advancement in improving arthrodesis reliability without requiring additional operative time or resources once established in the surgical protocol.
Read the full abstract on PubMed
Practical Takeaways
- •This 3D-printed aiming device is particularly valuable for less experienced surgeons performing PIPJ arthrodesis, significantly reducing operative time and radiation exposure while improving screw placement accuracy
- •The device may reduce the learning curve for PIPJ arthrodesis, making this technically demanding procedure more accessible to developing surgical skills
- •Experienced surgeons achieved optimal results with freehand technique, suggesting the device's greatest benefit is in supporting competency development rather than improving gold-standard outcomes
Key Findings
- •For inexperienced surgeons, the 3D-printed aiming device reduced procedure time by 25% (27.24 to 20.16 min, p<0.01)
- •Device use decreased intraoperative radiographs by 60% for inexperienced surgeons (6.1 to 2.1 images, p<0.01)
- •Screw placement accuracy improved 31% for inexperienced surgeons with the device (4.4 to 5.8 score, p<0.01)
- •For experienced surgeons, only radiograph reduction was significant (58% decrease); no improvement in procedure time, accuracy or symmetry