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膝关节截骨术患者特异性器械的适应症、技术及结果

Indications, Technique, and Outcomes of Patient Specific Instrumentation for Osteotomy About the Knee.

作者信息

Khela Harmon S, Khela Monty S, Sriram Varun, Schroeder Grant G, Hollyer Ian, Sherman Seth L

机构信息

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.

Creighton University School of Medicine, Omaha, NE, USA.

出版信息

Curr Rev Musculoskelet Med. 2025 Jul 9. doi: 10.1007/s12178-025-09987-2.

Abstract

PURPOSE OF REVIEW

Osteotomies around the knee are well-established techniques used to correct lower-extremity malalignment. While osteotomies of the proximal tibia and distal femur have traditionally been performed free-hand, the advent of Patient-Specific Instrumentation (PSI) in the form of custom 3D printed cutting guides and implants offers surgeons a greater ability to individualize surgical corrections to a patient's unique bony anatomy. This review aims to investigate the current state of the literature surrounding the use and outcomes of PSI for knee osteotomies and the benefits and drawbacks of PSI compared to traditional techniques.

RECENT FINDINGS

Recent studies have demonstrated the potential benefits of PSI in knee osteotomy, including improvements in the accuracy of planned corrections, reductions in operative time and fluoroscopy exposure, and similar patient-reported outcomes. While increased costs and lead time represent drawbacks to the use of PSI, the technology continues to evolve such that these areas may improve over time. For osteotomy of the distal femur and proximal tibia, PSI offers surgeons an opportunity to improve surgical precision intra-operatively, with similar outcomes and complication rates as compared to traditional osteotomy techniques.

摘要

综述目的

膝关节周围截骨术是用于矫正下肢力线不正的成熟技术。虽然传统上胫骨近端和股骨远端截骨术是徒手进行的,但以定制3D打印切割导板和植入物形式出现的患者特异性器械(PSI),使外科医生能够根据患者独特的骨骼解剖结构更个性化地进行手术矫正。本综述旨在研究围绕PSI用于膝关节截骨术的使用情况和结果以及与传统技术相比PSI的优缺点的当前文献状态。

最新发现

最近的研究表明PSI在膝关节截骨术中的潜在益处,包括计划矫正的准确性提高、手术时间和透视暴露减少,以及患者报告的结果相似。虽然成本增加和交货时间延长是使用PSI的缺点,但该技术不断发展,这些方面可能会随着时间的推移而改善。对于股骨远端和胫骨近端截骨术,PSI为外科医生提供了术中提高手术精度的机会,与传统截骨术技术相比,结果和并发症发生率相似。

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