Chui Elvis Chun-Sing, Mak Kyle Ka-Kwan, Ng Randy Hin-Ting, Fung Ericsson Chun-Hai, Chan Mei-Shuen, Yue Kai, Lau Lawrence Chun-Man, Chan Clifford Long-Fung, Yau Edmond Wing-Fung, Zhao Wei, Su Xiuyun, Zhang Jin, Xu Jianglong, Sang Hongxun, Pei Guoxian, Cheung Louis Wing-Hoi, Law Sheung-Wai, Ong Michael Tim-Yun, Yung Patrick Shu-Hang
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong, China.
Orthop Surg. 2025 Feb;17(2):593-602. doi: 10.1111/os.14274. Epub 2024 Dec 23.
High tibial osteotomy (HTO) is a surgical procedure for treating certain knee conditions. Proper execution of HTO can preserve joint function and delay or avoid the need for total knee replacement. This study compared different 3D printing techniques (fused deposition modeling, selective laser sintering, and direct metal laser sintering) and a navigation system for their suitability in assisting HTO surgeries.
Tibial saw-bones were used as models, and surgical guides and the navigation system were employed during the procedures. Six parameters (planning time, manufacturing time, delivery time, material cost, operation time, and accuracy) were evaluated. One-way analysis of variance (ANOVA) and t-test were used for the analysis.
The results showed that the metal surgical guides had the highest accuracy (angle differences mean, 2.4°) and operation time (mean 9.75 min), followed by plastic guides, classic guides, and the navigation system. The differences in accuracy were attributed to factors like rigidity, melting point, and errors during incisions.
The study recommended metal surgical guides as the best option for assisting HTO due to their accuracy and operation time. And the results have implications for orthopedic surgeons performing HTO surgeries, as they can use this information to improve postoperative outcomes, such as mechanical axis alignment and quality of life for HTO patients.
高位胫骨截骨术（HTO）是一种治疗特定膝关节疾病的外科手术。正确实施HTO可以保留关节功能，延迟或避免全膝关节置换的需要。本研究比较了不同的3D打印技术（熔融沉积建模、选择性激光烧结和直接金属激光烧结）以及一种导航系统在辅助HTO手术方面的适用性。
使用胫骨锯骨作为模型，并在手术过程中使用手术导板和导航系统。评估了六个参数（规划时间、制造时间、交付时间、材料成本、手术时间和准确性）。采用单因素方差分析（ANOVA）和t检验进行分析。
结果表明，金属手术导板的准确性最高（角度差异平均值为2.4°），手术时间最长（平均9.75分钟），其次是塑料导板、传统导板和导航系统。准确性的差异归因于诸如刚性、熔点和切口过程中的误差等因素。
该研究推荐金属手术导板作为辅助HTO的最佳选择，因其准确性和手术时间。研究结果对进行HTO手术的骨科医生具有启示意义，因为他们可以利用这些信息改善术后结果，如HTO患者的机械轴对齐和生活质量。
