The Clinical Effect Of 3D Printing Osteotomy Guide Assisted Total Knee Arthroplasty

Objective:3D printing knee osteotomy guide plate for total knee arthroplasty by preoperative CT scan in patients with knee joint,the data obtained is entered into the computer software,then the computer analyzes the data to determine the related parameters of femur and tibia and limb force line,and then simulate the total knee arthroplasty,femur and determine tibial osteotomy plane.Finally,the guiding plate for osteotomy was designed in the operation,and the surgical guide plate was obtained by 3D printing with medical materials.The purpose of this study is to compare the application of 3D printing technology to design knee joint osteotomy guide plate assisted knee arthroplasty and traditional treatment plan,evaluate the clinical efficacy and safety of 3D printing technology in total knee arthroplasty,and provide a theoretical basis for its clinical application Methods.Methods:67 patients who underwent unilateral total knee arthroplasty from June 2016 to October 2017 in the second hospital of Shanxi Medical University were selected and divided into control group(37 cases)and observation group(30 cases)according to operative method.The patients in the observation group received 3D printing knee osteotomy guide assisted knee replacement therapy,the control group received routine knee arthroplasty,and record the operation time,bleeding volume,postoperative drainage,postoperative complications,and postoperative 1 W and 1,3,12 months of U.S.special hospital of surgery of knee score(HSS score)as main index,the angle between the tangent line and coronal femoral condyle femoral anatomic axis(LDFA),the angle between the mechanical axis of the tibia and femur(MFTA),posterior tibial sagittal angle(STCA) and tibial plateau with tangent coronal tibial anatomical axis angle(MPTA as the imaging evaluation index).Results:1.The two groups of patients with knee pain and flexion and extension were significantly improved after operation,and the lower limb force line also achieved satisfactory results.2.The patients in the 3D printing group were significantly lower than the control group(p <0.05)in the time of operation,the amount of bleeding in the operation and the flow rate after the operation.3.The patients in the 3D printing group get a better HSS score than the conventional surgery group after 1d and 1months,the differences between groups were statistically significant(p<0.05),3D printing group and conventional surgery group had no significant difference on HSS score after 3 months and 6 months,the differences between groups were not statistically significant(p>0.05).4.No obvious neopathy was found between the 2 groups and after the operation.Conclusions:1.3D printing knee joint osteotomy guide plate assisted TKA operation has no difference in knee joint function,lower limb force line and joint mobility than conventional TKA operation.2.3D printing knee osteotomy guide plate assisted TKA operation has the advantages of less operative trauma,no harm to femoral medullary cavity,less postoperative drainage and less total bleeding after operation.It can play a good auxiliary role in TKA surgery,and is worthy of extensive promotion in clinical practice.