Application of 3D printed patient-specific instrumentation in distal tibial tuberosity-high tibial osteotomy

摘要

Objective:To observe the clinical efficacy and advantages of 3D printed patient-specific instrumentation(PSI)assisted distal tibial tuberosity-high tibial osteotomy in the treatment of medial compartment knee osteoarthritis.Methods:75 patients with medial compartment knee osteoarthritis were included in the study performed DTT-HTO in our hospital from August 2017 to August 2019.The patients were divided into the PSI group(n=39)and conventional group(n=36)According to whether PSI was used in surgery.The differences of lateral cortical fracture rate,time of intraoperative X-ray exposure,intraoperative blood loss,operative time,weight bearing line(WBL),Posterior tibial slope(PTS)and Caton-Deschamps index(CDI)were compared between the two groups.Visual analogue scale(VAS)scores and Hospital for Special Surgery(HSS)scores were recorded to evaluate knee pain and function before surgery and after surgery at 3 months and 12 months.Results:All 75 patients were followed up for more than 12 months,the ranged from 12-26(18.74±6.21)months.Three lateral cortical fractures in the conventional group and no fracture in PSI group.The lateral cortical fracture rate,time of intraoperative X-ray exposure,intraoperative blood loss,operative time in PSI group were lower than those in conventional group(p敿0.05).WBL in two groups were significantly improved after surgery(p敿0.05),and PTS,CDI were no statistically improved after surgery(p>0.05).While there was no statistically significant difference with WBL,PTS and CDI between two groups(p>0.05).At 1 months,3 months and 12 months after surgery;VAS and HSS scores in both groups were significantly improved compared with that before surgery(p0.05),and were no statistically significant difference between two groups.Conclusion:3D printed patient-specific instrumentation assisted DTT-HTO has significant clinical efficacy,and effectively standardized surgical procedures,meanwhile reduced the time of intraoperative X-ray exposure,intraoperative blood loss and risk of lateral cortical fracture.