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Joint Diseases and
Related Surgery
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Original Article · Open access

Patient-specific 3D printed guides for repairing posterior root tears of the medial meniscus: A cadaveric study

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María Durán-Serrano

Orthopedic and Trauma Surgery Service, Miguel Servet University Hospital, Zaragoza, Spain University of Zaragoza, Zaragoza, Spain

ORCID: 0000-0003-4039-7017

Ignacio Colom-Diaz

Younext/podoactiva, Institute for Advanced Orthopedic Research, Huesca, Spain

ORCID: 0009-0001-6221-8772

Antonio-Francisco Laclériga-Giménez

Orthopedic and Trauma Surgery Service, Viamed Montecanal Hospital, Zaragoza, Spain

ORCID: 0000-0001-8186-0907

Daniel Delfau-Lafuente

General Surgery Service, Alcañiz Hospital, Alcañiz (Teruel), Spain

ORCID: 0000-0002-9039-3965

Adrián Roche-Albero

Orthopedic and Trauma Surgery Service, Miguel Servet University Hospital, Zaragoza, Spain University of Zaragoza, Zaragoza, Spain

ORCID: 0000-0001-7441-8731

Miguel Lizcano-Palomares

Orthopedic and Trauma Surgery Service, Miguel Servet University Hospital, Zaragoza, Spain Orthopedic and Trauma Surgery Service, Viamed Montecanal Hospital, Zaragoza, Spain

ORCID: 0000-0003-3670-7713

Carlos Martín-Hernández

Orthopedic and Trauma Surgery Service, Miguel Servet University Hospital, Zaragoza, Spain

ORCID: 0000-0002-0858-0340

Abstract

Objectives: The aim of this study was to evaluate the accuracy of tibial tunnel placement using patient-specific three-dimensional (3D)-printed guides for repairing medial meniscus posterior root tears designed from magnetic resonance imaging (MRI) scans.

Materials and methods: Five right fresh-frozen cadaveric knees underwent MRI scanning with 1-mm isotropic slices. For each specimen, custom guides were created to generate two transosseous tibial tunnels, with design based on anatomical landmarks including the medial tibial eminence (MTE) and the posterior cruciate ligament (PCL) insertion. Guide design was done using Rhinoceros software, segmentation of bone structures and soft tissues in 3D Slicer, and printing in polyamide. After arthroscopic repair, computed tomography scans and anatomical dissections were performed to measure the accuracy of tunnel placement relative to the native medial meniscus posterior root attachment (MMPRA), the MTE, and the PCL. Individual pre- and postoperative measurements were compared to verify anatomical accuracy, and pooled data from all knees were analyzed.

Results: Individual evaluation showed minimal differences between pre- and postoperative measurements, ranging from 0.00 to 0.09 mm. Pooled analysis revealed no significant differences in the measurements taken: PCL-MMPRA (p = 0.313), MTEMMPRA (p = 0.705) or the width of MMPRA (p = 0.125). The guides enabled precise and reproducible tunnel placement, with consistent targeting of the anatomical footprint. Each guide cost approximately €30, with a production turnaround time of less than one week.

Conclusion: Patient-specific 3D-printed guides enable the effective creation of two anatomically accurate tibial tunnels for medial meniscus posterior root repair. This approach offers a rapid and precise solution for anatomical restoration using MRI-guided planning.

Declarations

Author Contributions

C.M.H.: Idea/concept; C.M.H., M.D.S.: Design, writing the article; A.R.A., A.F.L.G.: Control/ supervision; C.M.H., M.D.S., I.C.D.: Data collection and/or processing, analysis and/or interpretation; M.D.S., M.L.P., D.D.L.: Literature review; A.R.A., M.L.P., D.D.L., A.F.L.G., I.C.D.: Critical review.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This study received funding from the Spanish Arthroscopy Association.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

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