Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (12): 1881-1885.doi: 10.3969/j.issn.2095-4344.2544

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Application and comparison of personalized 3D printing with preoperative simulation and traditional method in high tibial osteotomy 

Chen Jinguo, Chen Guoxian, Lin Zongjin, Xu Guosong, Chen Weiyi, You Fengyuan   

  1. Department of Joint Surgery, First Hospital of Putian City, Putian 351100, Fujian Province, China
  • Received:2019-07-30 Revised:2019-08-02 Accepted:2019-09-06 Online:2020-04-28 Published:2020-03-01
  • Contact: Chen Guoxian, MD, Associate chief physician, Department of Joint Surgery, First Hospital of Putian City, Putian 351100, Fujian Province, China
  • About author:Chen Jinguo, Master, Attending physician, Department of Joint Surgery, First Hospital of Putian City, Putian 351100, Fujian Province, China
  • Supported by:
    a grant from Department of Education Science and Technology of Fujian Province, No. JAT160428; a grant from Science and Technology Bureau of Putian City of Fujian Province, No. 2016S3005

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Abstract:

BACKGROUND: High tibial osteotomy is a classic operation for the treatment of early simple medial compartment osteoarthritis of the knee. Three-dimensional (3D) printing can be used to make personalized surgical tools. We have used 3D printing technology to assist high tibial osteotomy for the treatment of knee osteoarthritis.

OBJECTIVE: By comparing traditional methods, to analyze the advantages and disadvantages of the high tibial osteotomy assisted by personalized 3D printing osteotomy combined with arthroscopic debridement for the treatment of osteoarthritis of the knee with varus deformity.

METHODS: Totally 47 cases undergoing lateral closed wedge high tibial osteotomy combined with knee joint debridement were randomly assigned to two groups. The 3D printing osteotomy group (n=21) received personalized 3D printing osteotomy. The traditional osteotomy group (n=26) received traditional osteotomy. The operation time, number of intraoperative C-arm fluoroscopy and blood loss, limb alignment on the affected side 1 month after surgery, and Hospital of Special Surgery scores on the affected side knee joints at 1, 3, 6, 12 and 24 months after surgery were compared between the two groups. This study was approved by the Ethics Committee of First Hospital of Putian City. All patients signed the informed consent.

RESULTS AND CONCLUSION: (1) The intraoperative 3D printing osteotomy module was consistent with the preoperative simulated place. (2) The operation time was significantly shorter in the 3D printing osteotomy group than in the traditional osteotomy group [(69.71±3.17), (92.92±5.91) minutes, t=-17.21, P < 0.01]. The number of C-arm fluoroscopy was significantly less in the 3D printing osteotomy group than in the traditional osteotomy group [(5.71±1.62), (18.15±3.00) times, t=-18.12, P < 0.01]. Blood loss was significantly less in the 3D printing osteotomy group than in the traditional osteotomy group [(275.24±53.82), (507.69±45.19) mL, t=-16.10, P < 0.01]. (3) There was no difference between the two groups in the limb alignment on the affected side at 1 month after operation and the Hospital of Special Surgery score on the affected knee at 24 months after operation (all P > 0.05). (4) In conclusion, compared with traditional osteotomy, personalized 3D printing-assisted osteotomy in lateral closed wedge high tibial osteotomy can significantly shorten the operation time, reduce the number of intraoperative C-arm fluoroscopy and the amount of blood loss, but there is no significant difference in knee function between the two groups at 2 years after surgery.

Key words: high tibial osteotomy, 3D printing, personalized osteotomy, traditional osteotomy, knee, osteoarthritis

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