use of 3D printed models for knee revision surgery

Background: Preoperative planning for complex primary and revision knee arthroplasty requires precise anatomical understanding, particularly in cases involving significant bone loss, osteolysis, or tumor pathology. While two-dimensional imaging and three-dimensional (3D) virtual reconstructions provide essential kinematic-geometric data, they may not fully translate into surgical execution for severe deformities or pelvic discontinuity.

Objective: This article evaluates the application of 3D-printed anatomical models in preoperative planning for complex knee revision surgery to improve component sizing accuracy and intraoperative efficiency.

Key Points: Utilizing high-resolution CT scans and DICOM data, 1:1 scale polylactic acid models are produced via fused deposition modeling. These models allow surgeons to perform "dry run" simulations using actual instrumentation to preselect implant sizes, stem lengths, offsets, and the necessity of augments, such as cones or sleeves. Clinical cases demonstrate that these models accurately replicate bony landmarks and defects, facilitating the identification of potential intraoperative complications, such as iatrogenic fractures during cone placement. Although the models lack soft tissue representation and possess different thermal properties than human bone, they facilitate a reduction in the number of required surgical instrument trays and optimize the surgical workflow.

Conclusion: Integrating 3D-printed models into revision knee surgery planning enhances surgical precision and confidence. By allowing for the pre-assembly of components and the elimination of unnecessary instrumentation, this technology offers significant potential for reducing operative time and perioperative costs while serving as a valuable educational tool for surgical training.