Research progress of individualized osteotomy guide plate in osteotomy around the knee
10.3760/cma.j.cn121113-20240121-00045
- VernacularTitle:个体化截骨导板在膝关节周围截骨术中的应用研究进展
- Author:
Zhihu ZHAO
1
;
Wei LUO
;
Jianxiong MA
;
Xinlong MA
Author Information
1. 天津市天津医院数字骨科技术与临床应用中心，天津 300211
- Keywords:
Knee joint;
Osteotomy;
Printing, three-dimensional;
Review
- From:
Chinese Journal of Orthopaedics
2024;44(20):1364-1370
- CountryChina
- Language:Chinese
-
Abstract:
Osteotomy around the knee includes medial opening wedge high tibial osteotomy (HTO), lateral closing wedge HTO, lateral opening wedge distal femoral osteotomy (DFO), medial opening wedge DFO, and double-site osteotomy. Osteotomy redistributes the knee joint pressure by correcting the lower limb alignment, which can effectively delay the progression of knee osteoarthritis. Currently, three methods are used to determine the intraoperative osteotomy angle: the pre-drilling method, wedge block insertion method, and angle-guided linkage method. Coronal plane accuracy is evaluated using the hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and ratio of lower limb weight-bearing line, while sagittal plane accuracy is assessed by measuring the posterior tibial slope (PTS). Individualized osteotomy guide plate can enhance osteotomy accuracy. The preparation process includes: (1) importing low-dose CT data of both lower limbs in DICOM format into reconstruction software to establish a 3D model of both lower limbs; (2) determining the osteotomy plane and distraction angle through threshold segmentation, importing the plate model, and establishing the length and position of each screw; (3) using fused deposition modeling to layer materials through a nozzle to create the 3D object. Individualized osteotomy guide plate in osteotomy around the knee can not only improve the accuracy of surgery, but also reduce the intraoperative fluoroscopy times and the incidence of complications. The operation efficiency and postoperative rehabilitation are better than those of traditional surgery. With the continuous upgrading of new materials and the improvement of design concepts, the accuracy and efficiency of individualized osteotomy guide will be further improved. Future research will focus on improving the degree of personalization of guide plate design and simplifying the manufacturing process.
