Tibial plateau fractures are complex injuries of the weight-bearing part of the knee. Proper treatment is essential to minimize the risk of post-traumatic osteoarthritis and disability. For an optimal treatment strategy, a thorough understanding of the fracture is crucial. Traditionally, decision-making is based on 2D imaging, which is highly dependent on the interpreter’s assessment. Currently, 3D technology is increasingly used to provide a more detailed view of the fracture and to enable more reliable measurements. In addition to improved decision-making, 3D technology offers many possibilities for personalized treatments.
This dissertation if Nick Assink focuses on improving (3D) measurement methods and personalizing treatment and outcome predictions for patients with tibial plateau fractures. First, the relationship between 2D measurements, fracture characteristics, and demographic data with functional outcomes was examined. Based on this knowledge, a predictive model for personalized outcome predictions was developed. In addition, Assink developed a new 3D measurement method and demonstrated both its reliability and its correlation with functional recovery.
Furthermore, the thesis explored how 3D technology can be applied in the operating room. It was shown that 3D-printed guides help translate a virtual plan into the operating room and that 3D surgical planning improves reduction compared to traditional methods. This personalized approach was further extended by developing and evaluating custom-made implants.
Due to the complexity of these fractures, surgery does not always result in the desired outcome. Personalized 3D technology also offers a precise solution for postoperative correction. This dissertation demonstrates that 3D-printed cutting and repositioning guides provide an accurate method to guide the surgeon toward the planned surgical outcome.
