Poster 238: Accuracy, Safety, and Cost of Patient-Specific Cutting Guides for Alignment-Correcting Osteotomy
Notice bibliographique
Résumé
Objectives: The purpose of this study was to determine the cost, accuracy of radiographic correction, and safety with respect to complication rates and fluoroscopic usage in patient-specific cutting guides (PSCG) osteotomies compared to an age- and body mass index (BMI)-matched group of controls using standard cutting guides (SCG). Methods: Patients were retrospectively reviewed between 2017 and 2022 at a single urban academic institution. Patients undergoing high tibial osteotomy (HTO) or distal femoral osteotomy (DFO) with PSCG (Bodycad 3d, Quebec, Canada) were identified. Traditional osteotomies were selected for the SCG group using propensity matching based on age, sex, BMI, osteotomy type. All procedures were performed by 1 of 2 fellowship-trained sports orthopaedic surgeons. Procedure time, fluoroscopy time, tourniquet time, and concomitant procedures were extracted from operative notes. Blinded, 2-reader hip-knee-ankle (HKA), posterior tibial slope (PTS) and mechanical axis deviation (MAD) measurements were performed on pre- and postoperative weightbearing radiographs for each procedure. Intraclass correlation coefficients (ICCs) were calculated to determine the reliability between the intended intraoperative correction of HKA and/or PTS the measured result on postoperative radiographs. A time-driven activity-based costing (TDABC) analysis was performed to compare costs of PSCG versus SCG. Results: Forty-two patients were included in the final analysis. Each group was 47.6% female, with 11 HTOs and 10 DFOs performed in each group. Final HKA (2.7° vs 1.9°, p = 0.355), PTS (1.6° vs 2.6°, p = 0.794) and MAD (10.2 vs 5.8 mm, p = 0.214) did not significantly differ between SCG and PSCG groups (MAD seems higher for SCG. The ICC between the intended and measured HKA correction was 0.841 (good) in the PSCG group and 0.623 (moderate) in the SCG group. PSCG osteotomies averaged 18.5 minutes less (p = 0.392) and required 16.7 minutes less tourniquet time (p = 0.121). Fluoroscopy time was significantly lower in the PSCG group compared to SCG (99 vs 43 seconds, p < 0.001), as well as radiation dose (7.8 vs 2.9 mGy, p = 0.013). TDABC analysis demonstrated a base cost of $21,067 for PSCG and $23,896 for SCG. When the cost of the cutting guide and pre-operative imaging were included, PSCG was $2,829 more expensive than SCG. There was a lower, though non-statistically significant, rate of hinge fractures (9.5% vs 33.3%, p = 0.130) and return to the OR (4.8% vs 19.0%, p = 0.343) when comparing PSCG and SCG groups. Conclusions: Both traditionally guided osteotomies and PSCG-guided osteotomies accurately corrected lower extremity malalignment. Utilization of PSCG resulted in similar procedure times and cost. PSCG required less fluoroscopy and resulted in less radiation to conventional osteotomy and trended toward a decreased rate of postoperative complications.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».