Application of personalized osteotomy guide plate in medial pivot knee prosthesis replacement based on MRI and three-dimensional CT
10.3969/j.issn.2095-4344.2807
- Author:
Xuxiang LI
1
Author Information
1. Department of Orthopedics, Nanjing Hospital Nanjing First Hospital, Affiliated to Nanjing Medical University
- Publication Type:Journal Article
- Keywords:
3D printing;
Medial pivot knee prosthesis;
MRI;
Navigation template;
Osteoarthritis;
Three-dimensional CT;
Total knee arthroplasty
- From:
Chinese Journal of Tissue Engineering Research
2020;24(30):4835-4840
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Personalized positioning guide plate based on three-dimensional CT data can improve the accuracy of posterior-stabilized prosthesis joint replacement, but bone structure reconstruction based on three-dimensional CT scan data ignores the thickness of distal femoral articular cartilage, which will affect the use of personalized osteotomy guide plate and the clinical effect of total knee arthroplasty. OBJECTIVE: To investigate the safety, accuracy and early clinical efficacy of three-dimensional printed screw positioning guide based on MRI and three-dimensional CT assisted medial pivot-total knee arthroplasty in the treatment of osteoarthritis. METHODS: A total of 110 patients with knee osteoarthritis admitted to Department of Orthopedics, Nanjing Hospital Affiliated to Nanjing Medical University from February 2018 to April 2019 were selected. All patients received medial pivot-total knee arthroplasty, and were randomly assigned to two groups. The 58 patients in the experimental group completed knee osteotomy with the assistance of personalized osteotomy guide plate based on MRI and three-dimensional CT. The 52 patients in the control group completed knee osteotomy with the traditional intramedullary and extramedullary positioning methods. The operation time and intraoperative blood loss of the two groups were recorded. Postoperative follow-up was conducted to review the X-ray films. KSS score of knee function and the visual analogue scale score were evaluated. RESULTS AND CONCLUSION: (1) 110 patients were followed up for 6-10 months without serious postoperative complications. (2) The operation time and intraoperative blood loss in the experimental group were less than those in the control group (P < 0. 01). (3) According to the reexamination of X-ray at 1 month after surgery, the deviation between the postoperative values and the theoretical design values of hip-genus-ankle angle, coronal femoral component angle, coronal tibial component angle and sagittal tibial component angle were all smaller in the experimental group than those of the control group (P < 0. 01). (4) KSS score of knee joint function in the experimental group 1, 3 and 6 months after the surgery was higher than that in the control group (P < 0. 05). There was no significant difference in visual analogue scale score between the two groups (P > 0. 05). (5) The results showed that the personalized osteotomy guide plate assisted internal axial knee prosthesis replacement based on MRI and three-dimensional CT could effectively improve the accuracy of prosthesis placement and shorten the operation time. The method was safe and feasible, and the early clinical effect was satisfactory.
