2023, Vol. 27 ›› Issue (13): 2051-2057

Feasibility of three-dimensional printing technology combined with computer-aided design in total knee arthroplasty for severe knee osteoarthritis

Wu Di1, Si Lina2, Wu Lizhu3, Wang Jianhua1, Luo Jinwei1, Chang Qiankun1, Lyu Yongming1, Du Yuanliang1   

Abstract: BACKGROUND: There are research reports on 3D printing technology and computer-aided design technology assisted total knee arthroplasty. It is not known whether their combination assisted total knee arthroplasty for treatment of knee osteoarthritis can achieve better results.  
OBJECTIVE: To explore the application value of 3D printing technology combined with computer-aided design technology in total knee arthroplasty for severe knee osteoarthritis.
METHODS: Totally 93 patients with severe knee osteoarthritis were prospectively selected in Affiliated Hospital of Chengde Medical College from October 2018 to October 2020. They were randomly divided into a control group (n=46) and an observation group (n=47), and underwent traditional artificial total knee arthroplasty and 3D printing technology + computer-aided design technology under the guidance of total knee arthroplasty. Pain degree, stress-related indicators, knee recovery rate, and complications were collected in both groups.  
RESULTS AND CONCLUSION: (1) The pain visual analogue scale score of the observation group at 7 and 14 days after operation was lower than that of the control group (P < 0.05); the levels of D-dimer and fibrinogen degradation products at 1 day after operation were lower in the observation group than those of the control group (P < 0.05); the level of hemoglobin was higher in the observation group than that of the control group (P < 0.05). (2) There was no significant difference between the two groups in hospital for special surgery knee score 6 months after operation (P > 0.05). The range of motion of the knee joint in the observation group was larger than that in the control group (P < 0.05); the angle of the lower limb force line was smaller in the observation group than that in the control group (P < 0.05). (3) At 6 months after operation, 1 case affected medial tibial plateau bone loss (total incidence of complications 2%) in the observation group. There were medial tibial plateau bone loss in 1 case, prosthesis loosening in 1 case, and incision infection in 2 cases (total incidence of complications 9%) in the control group. There was no significant difference in the incidence of complications between the two groups (P > 0.05). (4) It is indicated that compared with traditional total knee arthroplasty, 3D printing technology combined with computer-aided design technology in total knee arthroplasty for severe knee osteoarthritis can relieve pain, improve knee function, and reduce stress response.
Key words: knee osteoarthritis, 3D printing technology, computer-aided design, total knee arthroplasty, D-dimer, fibrinogen degradation product, knee function