Bionic design and manufacture of osteotomy guide plate for total knee arthroplasty
Objective To design and manufacture a total knee joint arthroplasty osteotomy guide plate(osteotomy guide plate)considering the size of prosthesis for the arthroplasty,and achieve rapid and accurate positioning and assisted osteotomy during operation.Methods The osteotomy guide plate was manufactured by FORMIGA P 110 3D printing equipment from German EOS company,and the printing material was polydodecyl lactam(PA12).The digital model of distal femur and prosthesis was obtained by CT,three-dimensional(3D)reconstruction of femur and reverse reconstruction of prosthesis.The reasonable size of prosthesis was determined by computer operation preview,the contact surface between distal femur and prosthesis was fixed as osteotomy plane,and other components were gradually assembled based on the plane.The model input format of 3D printing equipment was taken as pathological femur standard template library(STL).The osteotomy guide plate was produced by selec-tive laser sintering(SLS)technique,and the main printing material was polydodecalactam(PA12).After sterilization and disin-fection of manufactured product,it was used for 3 osteotomy operations for severe osteoarthritis from 2019 to 2021,which in-cluded 2 males and 1 female,aged 54-67 years old with mean age of 59 years old;the lesion was located on the left side in 1 case and on the right side in 2 cases.The operation was performed strictly according to guidelines for the use of osteotomy guide.The intraoperative and postoperative bleeding volume,operation time,hip-knee-ankle angle,tibiofemoral angle,Ameri-can Knee Society(AKS)score and Hospital for Special Surgery(HSS)knee function score were recorded to evaluate operation results.Results The osteotomy guide plate was successfully printed.Main sizes:vertical distance from the fixing screw hole to the osteotomy plane was 10.17-12.51 mm,the diameter of the anterior condylar fixing screw hole was 3.18 mm,width of the osteotomy groove was 1.42 mm,distance between the center point of the fixing screw was 45.44 mm,and diameter of the fixing screw hole was 3.16 mm.The results of the clinical trials showed that with the osteotomy guide plate used to locate distal femur in osteotomy operation,the section was in regular"8"shape,with no obvious overcutting or less cutting,which ensured the osteotomy accuracy.There was no interruption of surgery such as interference between swing saw and osteotomy guide plate or rupture of osteotomy guide plate occurred.The knee joint function of patients recovered well after operation,and no adverse reactions such as prosthesis loosening,subsidence,knee varus and valgus deformity,displacement,femoral end fracture and fat embolism occurred during the follow-up.Conclusion It is demonstrated that osteotomy guide plate designed and manufactured by experimental research could accurately locate.Compared to ordinary osteotomy tools,it has the function without opening marrow and one installation multiple positioning.The operation rehearsal based on 3D printing technique is conducive to determining the prosthesis specifications according to bone shape before surgery,familiarizing with osteotomy parameters,estimating difficulty of surgery,and considering various problems that may occur during surgery,so as to formulate an individualized and optimized operative plan suitable for patients.
NETL
NSTL
万方数据
维普
