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Three-dimensional Printing of Computed Tomography Images in Planification and Surgery Navigation of Patients with Charcot's Arthropathy of the Foot
Purpose or Learning Objective: (1) To recognize the characteristics of Charcot's arthropathy and current surgical treatments with their limitations; (2) to learn how three-dimensional (3D) printing models can aid surgical planning and intraoperative navigation; and (3) to become knowledgeable about 3D modeling and printing based on computed tomography (CT) images.
Methods or Background: Charcot's arthropathy of the foot, a progressive and destructive joint disorder, occurs in a neuropathic extremity. Diabetes is by far the most common risk factor, with a prevalence of 7.5% among patients with diabetic neuropathy. Surgery is a treatment option for advanced cases, aimed to reach articular off-loading reconstructions and solve or prevent skin ulceration and the progression of deformity. A major difficulty of the surgery is the deeply altered anatomy due to bone deformities and articular malalignment. This loss of anatomical landmarks thus leads to the challenging orientation required for a correct articular reconstruction.
Results or Findings: We describe our process to create 3D printed models based on CT images of patients with Charcot's arthropathy. It has proved to be a great help to surgeons with preoperative planning, explanation of the procedure to patients, and intraoperative anatomical navigation. We depict the process from CT acquisition and image processing to 3D printing of physical models. We also present our experience with the available software and some printers and printing materials. Finally, we discuss the benefit gained by clinicians using these models and their increasing potential in clinical scenarios.
Conclusion: Three-dimensional printing is a technology with many applications in different contexts and used increasingly in clinical settings. Charcot's arthropathy is a novel application of this technology with benefits to both patients and clinicians. We encourage radiologists to become familiar with 3D printing and lead its implementation in the workplace.
Article published online:
26 May 2023
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