关键词: 3D打印, 膝关节单髁置换, 个性化截骨导板, 中期, 长期, 疗效, 精准治疗, 假体生存率, 关节功能, 不良反应

Abstract: BACKGROUND: Unicompartmental knee arthroplasty is a commonly used surgical method for treating localized knee osteoarthritis, and its success relies on precise osteotomy and prosthesis positioning. Traditional techniques depend on the surgeon's experience and two-dimensional imaging, which makes it difficult to completely avoid alignment errors; these errors may affect the prosthesis survival rate and long-term efficacy.
OBJECTIVE: To systematically summarize the factors determining the mid- and long-term efficacy of unicompartmental knee arthroplasty, analyze the technical principles of personalized osteotomy guides based on 3D printing combined with digital design, artificial intelligence planning, and physical manufacturing, providing evidence to improve surgical accuracy. Furthermore, this article elaborates on enhancing surgical precision by optimizing biomechanics and reducing abnormal prosthesis wear, thereby improving prosthesis survival rate, maintaining joint function, and reducing the risk of adverse reactions.
METHODS: Relevant literature published in PubMed and China National Knowledge Infrastructure was searched, using Chinese and English search terms including “3D printing, unicompartmental knee arthroplasty, patient-specific instrumentation, mid-term, long-term, outcome.” After screening, a total of 65 articles were included for analysis.
RESULTS AND CONCLUSION: (1) Personalized osteotomy guides based on 3D printing significantly improved the surgical precision of unicompartmental knee arthroplasty through CT scanning, 3D reconstruction, and 3D printing customization. (2) Compared with traditional surgery, personalized osteotomy guides based on 3D printing reduced the error in coronal and sagittal prosthesis placement, improved lower limb alignment, increased prosthesis survival, and reduced mid- to long-term adverse reactions such as aseptic loosening. However, controversies remain regarding poor tibial rotation positioning, increased costs, and no significant advantage in short-term functional scores. (3) Compared with robot-assisted surgery, personalized osteotomy guides based on 3D printing have slightly lower precision, but a shorter learning curve and lower cost. Currently, this field lacks long-term randomized controlled evidence and relies heavily on high-quality imaging data, resulting in a long preoperative preparation period. (4) This article analyzes existing research on personalized osteotomy guides, summarizing the role of this technology in improving surgical precision. It also discusses its current status and limitations in terms of cost-effectiveness, clinical workflow integration, and the insufficient high-quality evidence. (5) To promote the widespread application of personalized guides in the precise treatment of unicompartmental knee arthroplasty, future research should focus on conducting multi-center long-term randomized controlled trials, integrating artificial intelligence and intraoperative dynamic navigation technology, and establishing efficacy prediction models based on real-world data. This will provide a more solid theoretical basis for its clinical application.

Key words: 3D printing, unicompartmental knee arthroplasty, personalized osteotomy guide, mid-term, long-term, efficacy, precision treatment, prosthesis survival rate, joint function, adverse reactions