2022, Vol. 26 ›› Issue (15): 2312-2316

Application of three-dimensional printed osteotomy guide plate in knee arthroplasty in osteoarthritis patients with concomitant femoral deformity

Liu Fatai1, Yang Jinshun2, Zhong Weibin1   

Abstract: BACKGROUND: For complex knee osteoarthritis, traditional surgical instruments for osteotomy positioning technology can easily lead to poor placement of artificial total knee arthroplasty prostheses. Personalized three-dimensional printed osteotomy guide plate can achieve accurate osteotomy and prosthesis placement.   
OBJECTIVE: To investigate the early clinical effects of total knee arthroplasty with personalized three-dimensional printed osteotomy guide plates in the treatment of advanced knee osteoarthritis with femoral deformities.
METHODS:   Thirty-one patients with severe knee osteoarthritis combined with femoral deformity admitted to the Fifth Affiliated Hospital of Guangzhou Medical University from June 2016 to May 2020 were enrolled in the study. There were 14 males and 17 females, which aged 54-88 years old. A personalized three-dimensional printed osteotomy guide plate was used to assist in total knee arthroplasty surgery. Imaging measurement was conducted before treatment and at 3 days after treatment, to measure the included angle between femur and tibia mechanical axis, posterior condylar angle, patella transverse axis-femoral transepicondylar axis angle. American Hospital of Special Surgery score, Visual Analogue Scale score and range of motion of the knee joint were measured and assessed before and at 6 and 12 months after treatment.   
RESULTS AND CONCLUSION: All the 31 patients were followed up for more than 12 months, and no adverse advents related to implant materials occurred during the trial and follow-up. At 3 days after treatment, the included angles between the femur and tibia mechanical axis, posterior condylar angle, and patella transverse axis-femoral transepicondylar axis angles were lower than those before treatment in all the patients (all P=0.000). At 6 and 12 months after treatment, the American Hospital of Special Surgery score and the range of motion of the knee were higher than those before treatment in all the patients (P < 0.05), while the Visual Analogue Scale scores were lower than those before treatment (P < 0.05). Therefore, total knee arthroplasty with the assistance of three-dimensional printed personalized osteotomy guide plates can relieve joint pain, improve joint function, restore lower limb force lines and femoral rotation alignment, and improve patellar trajectory in patients with advanced knee osteoarthritis combined with femoral deformities.

Key words: total knee arthroplasty, personalized osteotomy guide plate, lower limb force line, three-dimensional printing, artificial prosthesis, osteoarthritis, artificial joint, knee prosthesis