Clinical efficacy of three-dimensional printed individualized osteotomy guides combined with kinematic alignment in total knee arthroplasty
Objective:To investigate the efficacy of three-dimensional(3D)printed individualized osteotomy guides combined with kinematic alignment in total knee arthroplasty(TKA).Methods:A retrospective analysis was conducted on 80 patients with knee osteoarthritis treated from January 2020 to January 2023.Patient were divided into two groups according to their preference for surgical method,42 patients who underwent TKA using 3D printed individualized osteotomy guides combined with kinematic alignment(kinematic group)and 38 patients who underwent unilateral TKA using 3D printed individualized osteotomy guides combined with mechanical alignment(mechanical group).The following perioperative indicators were compared between the two groups(operative time,incision length,total blood loss[intraoperative and postoperative],time to first ambulation,incision healing status,length of hospital stay,visual analog scale[VAS]pain scores,the American Knee Society scores[KSS],range of motion[ROM]of the knee joint,and femorotibial angle[FTA]).Results:The follow-up period was 12 to 16 months,with a mean of(13.1±2.8)months.There were no intraoperative neurovascular injuries or serious postoperative complications such as infections or deep vein thrombosis in either group.The kinematic group had a significantly shorter time to first ambulation and length of hospital stay compared to the mechanical group(P<0.05).There were no significant differences between the two groups in operative time,incision length,total blood loss,or incision healing status(P>0.05).Preoperatively,there were no statistically significant differences between the two groups in VAS scores,KSS scores,knee joint flexion-extension ROM,or FTA(P>0.05).There were no significant differences between the two groups in preoperative VAS scores,KSS scores,knee joint flexion-extension ROM,or FTA(P>0.05).One month postoperatively,the kinematic group had lower VAS scores,higher KSS scores,greater knee joint flexion-extension ROM,and smaller FTA compare to the mechanical group(all P<0.05).At six-month and the final follow-up,the kinematic group had a significantly smaller FTA compared to the mechanical group(P<0.05),with no statistically differences in VAS scores,KSS scores,or knee joint flexion-extension ROM(P>0.05).Conclusions:The appliciation of 3D printed individualized osteotomy guides combined with kinematic alignment in TKA for patients with end-stage knee osteoarthritis is clinically effective,demonstrating high precision and safety.
3D PrintedTotal Knee ArthroplastyKinematic AlignmentMechanical Alignment
万方数据
维普
