A Patient with Osteoarthritis Knee and Prior Patella Fracture: Single Stage Fixation and Total Knee Arthroplasty: A Case Report.

INTRODUCTION: Osteoarthritis knee associated with periarticular fractures (femur, tibia, or patella) in geriatric patients is a treatment challenge for orthopedic surgeon. In geriatric patient, early mobilization is key for a better outcome and to prevent immobilization related complications. Hence, this case report is important for all orthopedic surgeons. CASE REPORT: We had a 65-year-old male patient who came for the treatment ofhis patella fracture and deformity ofboth knees. CONCLUSION: Elderly patients who sustained a patella fracture can be treated with single stage primary total knee replacement and fixation of patella fracture. There is no need for two stage surgery. Rehabilitation and pain relief along with mobilization is better with single stage surgery.

Error Analysis: How Precise is Fused Deposition Modeling in Fabrication of Bone Models in Comparison to the Parent Bones?

BACKGROUND: Rapid prototyping (RP) is used widely in dental and faciomaxillary surgery with anecdotal uses in orthopedics. The purview of RP in orthopedics is vast. However, there is no error analysis reported in the literature on bone models generated using office-based RP. This study evaluates the accuracy of fused deposition modeling (FDM) using standard tessellation language (STL) files and errors generated during the fabrication of bone models. MATERIALS AND METHODS: Nine dry bones were selected and were computed tomography (CT) scanned. STL files were procured from the CT scans and three-dimensional (3D) models of the bones were printed using our in-house FDM based 3D printer using Acrylonitrile Butadiene Styrene (ABS) filament. Measurements were made on the bone and 3D models according to data collection procedures for forensic skeletal material. Statistical analysis was performed to establish interobserver co-relation for measurements on dry bones and the 3D bone models. Statistical analysis was performed using SPSS version 13.0 software to analyze the collected data. RESULTS: The inter-observer reliability was established using intra-class coefficient for both the dry bones and the 3D models. The mean of absolute difference is 0.4 that is very minimal. The 3D models are comparable to the dry bones. CONCLUSIONS: STL file dependent FDM using ABS material produces near-anatomical 3D models. The high 3D accuracy hold a promise in the clinical scenario for preoperative planning, mock surgery, and choice of implants and prostheses, especially in complicated acetabular trauma and complex hip surgeries.