Sun Maolin, Yang Liu, He Rui, Hao Peng, Sun Jiawei
Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Mar 15;34(3):335-340. doi: 10.7507/1002-1892.201907045.
To investigate the effect of three-dimensional (3D) printing guide plate on improving femoral rotational alignment and patellar tracking in total knee arthroplasty (TKA).
Between January 2018 and October 2018, 60 patients (60 knees) with advanced knee osteoarthritis who received TKA and met the selection criteria were selected as the study subjects. Patients were randomly divided into two groups according to the random number table method, with 30 patients in each group. The TKA was done with the help of 3D printing guide plate in the guide group and following traditional procedure in the control group. There was no significant difference in gender, age, disease duration, side, and preoperative hip-knee-ankle angle (HKA), posterior condylar angle (PCA), patella transverse axis-femoral transepicondylar axis angle (PFA), Hospital for Special Surgery (HSS) score, and American Knee Society (AKS) score ( >0.05).
All incisions healed by first intention and no complications related to the operation occurred. All patients were followed up 10-12 months, with an average of 11 months. HSS score and AKS score of the two groups at 6 months after operation were significantly higher than those before operation ( <0.05), but there was no significant difference between the two groups ( >0.05). Postoperative X-ray films showed that the prosthesis was in good position, and no prosthesis loosening or sinking occurred during follow-up. HKA, PCA, and PFA significantly improved in the two groups at 10 months after operation compared with those before operation ( <0.05). There was no significant difference in HKA at 10 months between the two groups ( =1.031, =0.307). PCA and PFA in the guide group were smaller than those in the control group ( <0.05).
Application of 3D printing guide plate in TKA can not only correct the deformity of the knee joint and alleviate the pain symptoms, but also achieve the goal of the accurate femoral rotation alignment and good patellar tracking.
探讨三维（3D）打印导板在全膝关节置换术（TKA）中对改善股骨旋转对线及髌骨轨迹的作用。
选取2018年1月至2018年10月期间接受TKA且符合入选标准的60例晚期膝关节骨关节炎患者（60膝）作为研究对象。根据随机数字表法将患者随机分为两组，每组30例。导板组在3D打印导板辅助下进行TKA，对照组按照传统手术方法进行。两组患者在性别、年龄、病程、患侧及术前髋-膝-踝角（HKA）、后髁角（PCA）、髌骨横轴-股骨髁间轴角（PFA）、特种外科医院（HSS）评分及美国膝关节协会（AKS）评分方面比较，差异均无统计学意义（>0.05）。
所有切口均一期愈合，未发生与手术相关的并发症。所有患者均获随访10～12个月，平均11个月。两组患者术后6个月时HSS评分和AKS评分均显著高于术前（<0.05），但两组间比较差异无统计学意义（>0.05）。术后X线片显示假体位置良好，随访期间未发生假体松动或下沉。两组患者术后10个月时HKA、PCA及PFA较术前均显著改善（<0.05）。两组患者术后10个月时HKA比较，差异无统计学意义（=1.031，=0.307）。导板组PCA及PFA均小于对照组（<0.05）。
3D打印导板应用于TKA不仅能矫正膝关节畸形、缓解疼痛症状，还能实现股骨精确旋转对线及良好髌骨轨迹的目标。
