Three-dimensional printing technology-aided total knee arthroplasty for osteoarthritis with genu varum deformity

doi:10.3969/j.issn.2095-4344.2017.15.018

Abstract

Abstract:

BACKGROUND: The complicated localization of intramedullary nails and osteotomy more dependent on surgeons’ experience limit the application of conventional total knee arthroplasty (TKA). The occurrence of three-dimensional (3D) printing technology can achieve precise localization and osteotomy in TKA.

OBJECTIVE: To explore the effectiveness of 3D printing technology-aided TKA versus conventional TKA for genu varum.

METHODS: Thirty-four patients with genu varum undergoing primary unilateral TKA were recruited and were then divided into two groups (n=17 per group) in accordance with the random number table. One group was treated with TKA with 3D printing guild plate (3D printing group), while the other group received the conventional TKA (conventional group). The intraoperative and postoperative blood loss, operation time, as well as the Hospital for Special Surgery score, range of motion, and lower limb mechanical alignment at 2 weeks postoperatively were compared between two groups.

RESULTS AND CONCLUSION: (1) The range of motion of knee in the 3D printing group was larger than that in the conventional group, but had no significant difference at 2 weeks postoperatively (P=0.744). (2) There was no significant difference in the Hospital for Special Surgery scores between two groups at 2 weeks postoperatively (P= 0.532). (3) The postoperative lower limb mechanical alignment showed no significant difference between two groups (t=0.218, P=0.632). (4) The operation time in the 3D printing group was significantly shorter than that in the conventional group (P=0.000). (5) The blood loss in the 3D printing group was significantly less than that in the conventional group (P=0.000). (6) Our findings indicate that 3D printing technology-aided TKA exhibits similar results to the conventional TKA in the Hospital for Special Surgery scores, range of motion, and lower limb mechanical alignment, but it shortens the operation time, reduces the blood loss, and achieves precise osteotomy, which is available for the elderly with poor basic condition, and weak tolerance of surgery.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Osteoarthritis, Genu Varum, Tissue Engineering

CLC Number:

R318

Sun Zhen-guo, Zhu Jia-jun, Cui Yan, Ni Sheng-hui, Zhang Zhi-yu . Three-dimensional printing technology-aided total knee arthroplasty for osteoarthritis with genu varum deformity [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(15): 2395-2399.

Figures/Tables 6

References

[1] 张长杰肌肉骨骼康复学[M].北京:人民卫生出版社, 2008: 175-176.

[2] Olszewski R.Three-dimensional rapid prototyping models incraniomaxillofacial surgery:systematic review and new clinical applications.P Belg Roy Acad Med.2013;11(2):43-77.

[3] 潘伟,郝永强,严孟宁,等.个体化数字导板结合3D打印技术在旋转铰链型人工膝关节置换术中的应用[J].国际骨科学杂志, 2015, 36(3): 231-234.

[4] Stindel E, Briard JL, Merloz P,et al.Bone morphing: 3D morpho-logical data for total knee arthroplasty. Comput Aided Surg.2002; 7(3): 156-168.

[5] 康鹏德,杨静,沈彬,等. Crowe IV型髋关节发育不良全髋关节置换术前计算机辅助设计[J].中华骨科杂志, 2012, 32(5): 442-446.

[6] Zhang S,Liu X, Xu Y, et al. Application of rapid prototyping fortemporomandibular joint reconstruction. J Oral Maxillofac Surg.2011;69(2): 432-438.

[7] Lin SJ, Lee CY, Huang KC, et al. Improved femoral component rotation in advanced genu valgum deformity using computerassisted measured resection total knee arthroplasty. J OrthopSurgRes.2015;10: 135.

[8] Heyse TJ,Tibesku CO.Improved tibial component rotation in TKA using patient-specifi c instrumentation. Arch Orthop Trauma Surg.2015;135(5):697-701.

[9] Heyse TJ, Tibesku CO. Improved femoral component rotation in TKA using patient-specific instrumentation.Knee.2014; 21(1):268-271.

[10] Innocenti B, Bellemans J, Catani F. Deviations from optimal alignment in TKA: Is there a biomechanical difference between femoral or tibial component alignment? J Arthroplasty. 2016;31(1):295-301.

[11] Daniilidis K,Tibesku CO.Frontal plane alignment after total knee arthroplasty using patient-specific instruments.Int Orthop. 2013;37(1):45-50.

[12] 李伟,方学伟,周游,等.基于MＲI 技术全膝关节置换术中个体化导航模板的基础研究[J/CD].中华关节外科杂志: 电子版, 2015, 9(1) :71-77.

[13] Shen C,Tang ZH,Hu JZ,et al.Patient-specific instrumentation does not improve accuracy in total knee arthroplasty. Orthopedics.2015;38(3):e178-188.

[14] Bae DK, Song SJ, Heo DB, et al. Does the severity of preoperativevarus deformity influence postoperative alignment in bothconventional and computer-assisted total knee arthroplasty? KneeSurg Sports TraumatolArthrosc. 2013;21(10): 2248-2254.

[15] 汪锡龙,尚希福,贺瑞,等.关节内注射氨甲环酸联合引流管夹闭3 小时方案减少初次单膝关节置换术患者围术期失血的有效性及安全性研究[J].中国全科医学,2015, 18(6): 657-660, 664.