Utility of a Three Dimensional Printed Color-coded Bone Model to Visualize Impinging Osteophytes for Arthroscopic Debridement Arthroplasty in Elbow Osteoarthritis.

Abstract Background The identification and precise removal of bony impingement lesions during arthroscopic debridement arthroplasty for elbow osteoarthritis requires a high level of experience and surgical skill. We have developed a new technique to identify the impinging osteophytes on a computer display by simulating elbow motion using the multiple positions of three-dimensional (3D) elbow models created from computed tomography data. Moreover, an actual color-coded 3D model indicating the impinging osteophytes was created with a 3D printer and was used as an intraoperative reference tool. This study aimed to verify the efficacy of these new technologies in arthroscopic debridement for elbow osteoarthritis. Methods We retrospectively studied 16 patients treated with arthroscopic debridement for elbow osteoarthritis after a preoperative computer simulation. Patients who underwent surgery with the preoperative simulation only were assigned to Group 1 (n = 8), and those upon whom we operated using a color-coded 3D bone model created from the preoperative simulation were assigned to Group 2 (n = 8). Extension and flexion elbow range of motion (ROM), the Mayo Elbow Performance score (MEPS), and severity of osteoarthritis were compared between the groups. Results Although preoperative elbow flexion and MEPS were not significantly different between the groups, preoperative extension was significantly more restricted in Group 2 than in Group 1 (p = 0.0131). Group 2 tended to include more severe cases in the Hasting and Rettig classification (p = 0.0693). ROM and MEPS were improved in all cases. No significant differences in postoperative ROM or MEPS were observed between the groups. There were no significant differences in the improvement in ROM or MEPS between the two groups. Conclusions The use of preoperative simulation and a color-coded bone model could help to achieve as good postoperative ROM and MEPS for advanced elbow osteoarthritis as those for early or intermediate stages.