3D打印截骨导板辅助下的TKA手术在河西走廊地区的临床应用

doi:10.13418/j.issn.1001-165x.2019.06.017

Abstract

Abstract: Objective　To compare the differences of clinical efficacy between 3D printing technology surgical method and conventional surgical method in total knee arthroplasty (TKA), and to investigate the application of 3D printing osteotomy technique assisted TKA in the treatment of knee arthropathy.　Methods　From October 2015 to June 2018, 136 knees of 120 patients with TKA were randomly divided into two groups, a 3D group and a conventional group. The 60 patients in the 3D group (70 knees) used 3D printing osteotomy guide plate to assist the TKA operation. The 60 patients (66 knees) in the conventional group adopted the traditional TKA method over the same period. There were no significant differences in age, gender and knee society score grade among two groups before operation (P>0.05). Operation time, the actual distal femur and the osteotomy data of proximal tibia during operation were recorded. The mechanical femur tibia angle (MFTA), the sagittal tibia plateau caster angle (STCA) of two groups after operation were measured by X-ray and were analyzed statistically, and the knee society score (KSS) was recorded and compared between the two groups at the end of the follow-ups. 　Results　All patients were followed up for 9~32 months, no infection, prosthesis loosening or motion was observed in two groups. No significant differences in the distal femur and the osteotomy data of proximal tibia were found between the planned value in 3D group and the actual value in the operation (P＞0.05). There were statistical significances in operation time, MFTA value and STCA value between 3D group and conventional group (P<0.05). The 3D group had better clinical and functional grade in KSS than the conventional group during the last follow-ups. and there were statistical significances (P＜0.05).　Conclusion　The 3D printing technique can simplify the operation procedure, improve the surgical accuracy and the clinical efficacy, making it worthy of further promotion.

Key words: Knee-joint, 　Arthroplasty, 　3D printing, 　Osteotomy, 　Personalized

CLC Number:

R687.42

NIU Ming, MA Ju-rong, WU Xu-nian, WANG Tong, CAI Jing-wei, WANG Xu-bo . Clinical application of TKA surgery assisted by 3D printing osteotomy guide plate in Hexi Corridor [J]. Chinese Journal of Clinical Anatomy, 2019, 37(6): 697-704.

References 15

[1]	Victor J, Dujardin J, Vandenneucker H, et al. Patient-specificguides do not improve accuracy in total knee arthroplasty: aprospective randomized controlled trial[J]. Clin Orthop Relat Res, 2014, 472(1): 263-271.
[2]	Malhotra R, Singla A, Lekha C, et al. A prospective randomizedstudy to compare systemic emboli using the computer-assisted andconventional techniques of total knee arthroplasty[J]. J Bone Joint Surg Am, 2015, 97(11): 889-894.
[3]	Iorio R, Bolle G, Conteduca F, et al. Accuracy of manualinstrume ntation of tibial cutting guide in total knee arthroplasty[J]. Knee Surg Sports Traumatol Arthrosc, 2013, 21(10): 2296-2300.
[4]	Krishnan SP, Dawood A, Richards R, et al. Areview of rapid prototyped surgical guides for patient-specific total knee replacement[J]. J Bone Joint Surg Br, 2012, 94(11): 1457-1461.
[5]	Cozmei C, Caloian F. Additive manufacturing flickering at thebeginning of existence[J]. Procedia Economics and Finance, 2012, 3(12): 457-462.
[6]	Nunley RM, Ellison BS, Ruh EL, et al. Are patient-specific cuttingblocks cost-effective for total knee arthroplasty[J]. Clin Orthop Relat Res, 2012, 470(3): 889-894.
[7]	Lachiewicz PF, Henderson RA. Patient-specific instruments fortotal knee arthroplasty[J]. J Am Acad Orthop Surg, 2013, 21(9): 513-518.
[8]	吴东迎, 袁峰, 吴继彬, 等. 3D打印截骨导板在人工全系关节置换术中的应用[J]. 中华骨科杂志, 2015, 35(9): 921-926.
[9]	刘峰, 张勇, 朱庭标, 等. 3D打印截骨导板辅助TKA治疗膝外翻畸形[J]. 中国骨与关节损伤杂志, 2017, 32(3): 329-331.
[10]	Cip J, Widemschek M, Luegmair M, et al. Conventional versus computer-assisted technique for total knee arthroolasty: a minimum of 5-year follow-up of 200 patients in a prospective randomized comparative trial[J] . J Arthroplasty, 2014, 29(9): 1795-1802.
[11]	Harvie P, Sloan K , Beaver RJ. Computer navigation vs conventional total knee arthroplasty five-year functional results of a prospective randomized trial[J]. J Arthroplasty, 2012, 27(5): 667-672.
[12]	Gøothesen O, Espehaug B, Havelin LI, et al. Functional outcome and alignment in computer-assisted and conventionally operated total knee replacements: a multicentre parallel-group randomised controlled trial[J]. Bone Jiont J, 2014, 96-B(5): 609-618.
[13]	Song EK, Seon JK, Yim JH, et al. Robotic-assisted TKA reduces postoperative alignment outliers and improves gap balance compared to conventional TKA[J]. Clin Orthop Relat Res, 2013, 471(1): 118-126.
[14]	Bell SW, Anthony I, Jones B, et al. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study[J]. J Bone Joint Surg Am, 2016, 98(8): 627-635.
[15]	Pearle AD, O'Loughlin PF, Kendoff DO. Robot-assisted unicompartmental knee arthroplasty[J]. J Arthroplasty, 2010, 25(2): 230-237.

Clinical application of TKA surgery assisted by 3D printing osteotomy guide plate in Hexi Corridor

Knowledge

Abstract

Cite this article

share this article

References 15

Related Articles 15

Metrics

Comments

Recommended 0

[1]	Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui. An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 77-82.
[2]	Li Jiawei, Gao Mingjie, Tong Ling, Liu Qinghua, Kang Zhijie, Zhang Kai, Wang Haiyan, Li Xiaohe. Digital measurement and analysis of acetabular morphology in Mongolian population of Inner Mongolia [J]. Chinese Journal of Clinical Anatomy, 2023, 41(4): 390-394.
[3]	Liu Yu, Gu Sanjun, Xu Yaozeng, Li Haifeng, Wei Changbao, Yin Qin . Reason and strategies of intraoperative complications of minimally invasive hip arthroplasty using SuperPATH approach in the treatment of elderly patients with femoral neck fracture [J]. Chinese Journal of Clinical Anatomy, 2023, 41(4): 465-469.
[4]	Yang Xi, Xu Yongqing, Liu Wuhua, Xu Yujian, Shi Yan, Fang Xiang, He Xiaoqing. Effect of repairing of annular ligament on the pediatric chronic Monteggia fracture [J]. Chinese Journal of Clinical Anatomy, 2023, 41(4): 470-474.
[5]	Li Ming, Jia Bingshen, Jiao Tuo, Zhang Ying, Fu Kun. Effect of non-whole time tourniquet application on perioperative outcomes of arthroscopic combined high tibial osteotomy [J]. Chinese Journal of Clinical Anatomy, 2023, 41(4): 475-480.
[6]	Wang Jianhua, Wu Di, Sun He, Zhang Yilong, Xin Lili, Li Le. Follow-up of the clinical efficacy and sagittal balance of 3D printing spine intervertebral fusion cage in treatment of cervical spondylosis [J]. Chinese Journal of Clinical Anatomy, 2023, 41(3): 342-348.
[7]	Li Jun, Liang Shuai, Wang Jian. Application of simulated surgery combined with 3D printing patient-specific instrumentation in high tibial osteotomy [J]. Chinese Journal of Clinical Anatomy, 2023, 41(3): 354-359.
[8]	Ma Dong, Wang Yining, Xu Chujiang, Xiao Jin, Feng Zhengkuan, Xu Guangwei, Yu Wanqi, Qian Lei, Ouyang Jun. Biomechanical effect of the distal Chevron osteotomy on contact characteristics of foot joints of hallux valgus [J]. Chinese Journal of Clinical Anatomy, 2023, 41(1): 81-86.
[9]	Chen Senrong , Xiao Jun, Li Qiang , Hu Yong , Shi Zhanjun . Effects of tranexamic acid and different anticoagulants on perioperative blood loss in total knee arthroplasty [J]. Chinese Journal of Clinical Anatomy, 2022, 40(3): 356-361.
[10]	Zhao Yiqi, Huang Guiwu, Li Wenchang, Zheng Linli, Zuo Nan, Ling Qianhui, Shi Guangyue, Wu Peihui. Morphological characteristics of femoral shaft and their influences on femoral valgus angle in southern China [J]. Chinese Journal of Clinical Anatomy, 2022, 40(1): 4-9.
[11]	Shen Guodong, Zou Yunxuan, Zhang Hongning, Yang Kangyong, Lai Zhibin, Zhu Yongzhan. Clinical efficacy of minimally Juvara combined with Akin osteotomy on severe hallux valgus [J]. Chinese Journal of Clinical Anatomy, 2022, 40(1): 89-92.
[12]	Zhang Xiangnan, Deng Wei, Zhang Songqiang, Wang Hongyu, Li Lei, Ju Wen, Zhou Guangliang, Ju Faxin, Zhou Zhenghu, Li Guanxing, Ju Jihui, Hou Ruixing. Fabrication of cast specimen of internal femoral head artery by microperfusion combined with 3D printing [J]. Chinese Journal of Clinical Anatomy, 2022, 40(1): 103-106.
[13]	Xue Haowen, Chu Hongyu, Zuo Xiepeng, Wu Kehui, Han Qing, Cheng Kailiang, Yang Yanyan, Zhu Qingsan. Three-dimensional morphological analysis and application research of ankle joint in Chinese normal adults based on CT [J]. Chinese Journal of Clinical Anatomy, 2021, 39(5): 539-545.
[14]	Su Weiwei, He Zaopeng, Zhang Guodong, Li Wei, Xu Jing, Liao Zhengwen, Xie Pusheng, Lin Dongxin, Huang Wenhua. Accurate localization and removal of deeply imbedded metallic foreign bodies in human limbs assisted by positioning device [J]. Chinese Journal of Clinical Anatomy, 2021, 39(2): 148-153.
[15]	ZHANG Yong , ZHANG Yan-ru , YANG Yun-feng , LU Yan , TONG Zhao-hui. Study on the accuracy of three dimensional reconstruction and three dimensional printing technique in the measurement of pelvic three dimensional features [J]. Chinese Journal of Clinical Anatomy, 2020, 38(6): 697-702.