3-Dimensional Printed Models May Be a Useful Tool When Planning Revision Anterior Cruciate Ligament Reconstruction

Abstract

Purpose: To determine whether using 3-dimensional (3D)-printed models in addition to computed tomography (CT) scans to evaluate the primary femoral and tibial tunnels before revision anterior cruciate ligament (ACL) reconstruction leads to better agreement with the surgical approach than CT alone. Methods: Fifteen patients who underwent revision ACL reconstruction were retrospectively identified. The mean age was 24.3 years, and 73% were female. Using only CT images, 3 board-certified orthopaedists and 5 sports medicine orthopaedic fellows evaluated whether the existing tibial and femoral tunnels were acceptable for the revision surgery. Subsequently, 3D-printed models were made available in addition to the CT scan, and the same questions were asked. Results: For the attending orthopaedic physicians, adding the 3D-printed models did not have a significant impact on the tibial or femoral tunnel agreement compared with the surgical approach. With the fellow physicians, however, using the 3D-printed models with tibial tunnel evaluation led to a higher agreement rate (76%) compared with CT images alone (63%) (P = .050). Furthermore, with the fellow physicians, there was a higher overall agreement when evaluating both the tibial and femoral tunnels with the addition of 3D-printed models (74%) compared with CT alone (65%) (P = .049). Conclusion: Our hypothesis that using 3D-printed models leads to better agreement with the surgical approach was unsupported based on the response of the board-certified orthopaedists. Based on the fellow response, it stands to reason that 3D-printed models may be a useful tool in understanding spatial orientation when planning for revision ACL surgery. Level of Evidence: IV, retrospective case series.