Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (18): 2789-2793.doi: 10.3969/j.issn.2095-4344.3834

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Application of three-dimensional printing guide plate in total knee arthroplasty for patients with varus and valgus deformity

Huang Chenyu1, 2, 3, Tang Cheng1, 2, 3, Wei Bo1, 2, 3, Li Jiayi1, 2, 3, Li Xuxiang1, 2, 3, Zhang Huikang2, 3, Xu Yan2, 3, Yao Qingqiang1, 2, 3, Wang Liming1, 2, 3   

  1. 1Department of Orthopedics, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, Jiangsu Province, China; 2Institute of Digital Medicine, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China; 3Jiangsu Digital Medicine and 3D printing Clinical Engineering Research Center, Nanjing 210006, Jiangsu Province, China 
  • Received:2020-05-11 Revised:2020-05-16 Accepted:2020-07-31 Online:2021-06-28 Published:2021-01-11
  • Contact: Wang Liming, Master, Chief physician, Department of Orthopedics, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China; Jiangsu Digital Medicine and 3D printing Clinical Engineering Research Center, Nanjing 210006, Jiangsu Province, China
  • About author:Huang Chenyu, Master, Department of Orthopedics, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, Jiangsu Province, China; Institute of Digital Medicine, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China; Jiangsu Digital Medicine and 3D printing Clinical Engineering Research Center, Nanjing 210006, Jiangsu Province, China
  • Supported by:
    the Science and Technology Project in Jiangsu Province, No. BE2019679 (to WLM); the Nanjing Science and technology development plan, No. 201805001 (to WLM); the National Natural Science Foundation of China, No. 81972042 (to WLM) 

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Abstract: BACKGROUND: In recent years, three-dimensional (3D) printing technology has been widely used in the fields of navigation fracture internal fixation, spinal screw implantation and huge bone defect repair and reconstruction. However, there are few reports on the application of 3D printing navigation template in total knee arthroplasty for patients with varus and valgus knee joint. 
OBJECTIVE: To compare the effect of 3D printing surgical guide plate assisted total knee arthroplasty and traditional total knee arthroplasty in the treatment of knee varus and valgus osteoarthritis.
METHODS: Totally 39 patients with knee osteoarthritis were selected in Nanjing Hospital Affiliated to Nanjing Medical University from January 2019 to February 2020, including 18 females, 21 males, aged 55-83 years old, and randomly divided into two groups. Patients in the trial group (n=20) underwent total knee arthroplasty with 3D printing guide plate. Patients in the control group (n=19) underwent traditional total knee arthroplasty. X-ray films were taken after operation to measure the coronal tibial component angle, sagittal tibial component angle, coronal femoral component angle, sagittal femoral component angle, hip-knee-ankle angle, and angle of lower limb force line. The hospitalization time, operation time, intraoperative blood loss, and postoperative drainage volume were recorded in both groups. Visual analogue scores and American knee society knee scores were performed at 1 day, 1 week, 2 weeks, 1 month and 3 months after operation. The trial was approved by the Ethics Committee of Nanjing Hospital Affiliated to Nanjing Medical University.
RESULTS AND CONCLUSION: (1) The deviation values of coronal tibial component angle, sagittal tibial component angle, coronal femoral component angle, sagittal femoral component angle and hip-knee-ankle angle in the two groups were all < 3°, and the adjustment effect of the trial group on the angle of lower limb force line was better than that of the control group (P < 0.05). (2) The operation time, intraoperative blood loss and postoperative drainage volume of the trial group were less than those of the control group (P < 0.05). There was no significant difference in hospital stay between the two groups (P > 0.05). (3) The visual analogue scale scores of the trial group at 1 day and 1 week after operation were lower than those of the control group (P < 0.05), and the American knee society knee scores were higher than that of the control group (P < 0.05). (5) The results showed that for patients with severe varus and valgus of the knee joint, 3D printing surgical guide plate assisted knee arthroplasty improved the operation accuracy and saved the intraoperative time.

Key words: bone, implant, prosthesis, 3D printing guide plate, total knee arthroplasty, varus and valgus deformity, osteoarthritis

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