Short-term effectiveness of total knee arthroplasty assisted by three-dimensional printing osteotomy navigation template_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Dejian ,  LI Yanlin , CAI Guofeng , JIA Di , MAO Jianyu , MENG Xuhan , WANG Guoliang , HE Chuan

Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P.R.China;

Corresponding author：

LI Yanlin, Email: 852387873@qq.com

Keywords：

Total knee arthroplasty; three-dimensional printing; osteotomy navigation template; knee joint kinematics

DOI：

10.7507/1002-1892.201802013

Video：

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ObjectiveTo investigate the short-term effectiveness of total knee arthroplasty (TKA) assisted by three-dimensional (3D) printing osteotomy navigation template.MethodsA retrospective study was performed on 60 patients with osteoarthritis bewteen January 2016 and June 2017. Thirty cases underwent TKA assisted by 3D printing osteotomy navigation template (3D printing group) and 30 cases underwent the conventional TKA (conventional TKA group). There was no significant difference in gender, age, body mass index, surgical side, and disease duration between 2 groups (P>0.05). The operation time, the pre- and post-operative hemoglobin values, the amount of drainage, the Hospital for Special Surgery (HSS) score and Knee Society Score (KSS) of knee joint before operation and at 3 months after operation were observed. And 6 freedom degrees of knee (the varus and valgus angle, the internal and external rotation angle, the antero-posterior displacement, the proximal-distal displacement, the flexion and extension angle, and the internal and external displacement) before operation and at 3 months after operation were recorded by Opti-Knee (the knee 3D motion analysis system). The values of 2 groups were compared with 30 healthy adults (<60 years).ResultsThe operation time was shorter in 3D printing group than that in conventional TKA group (t=5.833, P=0.000). The hemoglobin values at 1 and 3 days after operation were higher in 3D printing group than those in conventional TKA group (P<0.05). The amount of drainage was less in 3D printing group than that in conventional TKA group (t=5.468, P=0.000). All patients were followed up 6-9 months (mean, 7.3 months). There was no significant difference in pre- and post-operative HSS score and KSS clinical score between 2 groups (P>0.05). There was no significant difference in preoperative KSS function score between 2 groups (P>0.05), but the KSS function score of 3D printing group at 3 months after operation was higher than that of conventional TKA group (P<0.05). Before operation, the varus and valgus angle, the internal and external rotation angle, the antero-posterior displacement, the proximal-distal displacement of 3D printing group and conventional TKA group were larger than that of the healthy adults (P<0.05); there was no significant difference in the flexion and extension angle and the internal and external displacement between 2 groups and healthy adults (P>0.05). At 3 months after operation, compared with healthy adults, the varus and valgus angle of conventional TKA group was increased, the flexion and extension angle of conventional TKA group was decreased (P<0.05); the proximal-distal displacement and the internal and external displacement of 2 groups were decreased (P<0.05); there was no significant difference in other freedom degrees between groups (P>0.05). No sign of prosthesis loosening was observed by X-ray examination.ConclusionCompared with the traditional TKA, TKA assisted by the 3D printing osteotomy navigation template had such advantages as shorter operation time, less postoperative blood loss, and well postoperative recovery.

Citation： LIU Dejian, LI Yanlin, CAI Guofeng, JIA Di, MAO Jianyu, MENG Xuhan, WANG Guoliang, HE Chuan. Short-term effectiveness of total knee arthroplasty assisted by three-dimensional printing osteotomy navigation template. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(7): 899-905. doi: 10.7507/1002-1892.201802013 Copy

1.	Thienpont E, Paternostre F, Pietsch M, et al. Total knee arthroplasty with patient-specific instruments improves function and restores limb alignment in patients with extra-articular deformity. Knee, 2013, 20(6): 407-411.
2.	Lustig S, Scholes CJ, Oussedik SI, et al. Unsatisfactory accuracy as determined by computer navigation of VISIONAIRE patient-specific instrumentation for total knee arthroplasty. J Arthroplasty, 2013, 28 (3): 469-473.
3.	Victor J, Dujardin J, Vandenneucker H, et al. Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial. Clin Orthop Relat Res, 2014, 472(1): 263-271.
4.	MacDessi SJ, Jang B, Harris IA, et al. A comparison of alignment using patient specific guides, computer navigation and conventional instrumentation in total knee arthroplasty. Knee, 2014, 21(2): 406-409.
5.	Conteduca F, Iorio R, Mazza D, et al. Are MRI-based, patient matched cutting jigs as accurate as the tibial guides? Int Orthop, 2012, 36 (8): 1589-1593.
6.	Malhotra R, Singla A, Lekha C, et al. A prospective randomized study to compare systemic emboli using the computer-assisted and conventional techniques of total knee arthroplasty. J Bone Joint Surg (Am), 2015, 97(11): 889-894.
7.	Song IS, Sun DH, Chon JG, et al. Results of revision surgery and causes of unstable total knee arthroplasty. Clin Orthop Surg, 2014, 6(2): 165-172.
8.	Schotanus MGM, Schoenmakers DAL, Sollie R, et al. Patient specifc instruments for total knee arthroplasty can accurately predict the component size as used peroperative. Knee Surg Sports Traumatol Arthrosc, 2017, 25(12): 3844-3848.
9.	Lachiewicz PF, Henderson RA. Patient-specific instruments for total knee arthroplasty. J Am Acad Orthop Surg, 2013, 21(9): 513-518.
10.	吴东迎, 袁峰, 吴继彬, 等. 3D 打印截骨导板在人工全系关节置换术中的应用. 中华骨科杂志, 2015, 35(9): 921-926.
11.	White D, Chelule KL, Seedhom BB. Accuracy of MRI vs CT imaging with particular reference to patient specific templates for total knee replacement surgery. Int J Med Robot, 2008, 4(3): 224-231.
12.	Nunley RM, Ellison BS, Ruh EL, et al. Are patient-specific cutting blocks cost-effective for total knee arthroplasty? Clin Orthop Relat Res, 2012, 470(3): 889-894.
13.	Cozmei C, Caloian F. Additive manufacturing flickering at the beginning of existence. Procedia Economics and Finance, 2012, 3(12): 457-462.
14.	邱贵兴. 骨关节炎诊治指南 (2007 年版). 中华关节外科杂志 (电子版), 2007, 1(4): 281-285.
15.	Slover JD, Rubash HE, Malchau H, et al. Cost-effectiveness analysis of custom total knee cutting blocks. J Arthroplasty, 2012, 27(2): 180-185.
16.	de Steiger RN, Liu YL, Graves SE. Computer navigation for total knee arthroplasty reduces revision rate for patients less than sixty-five years of age. J Bone Joint Surg (Am), 2015, 97(8): 635-642.
17.	Ullrich B, Stening J, Pelzer T, et al. Long-term data of gait characteristics and moment–knee angle relations in female total knee arthroplasty patients. Clin Biomech (Bristol, Avon), 2015, 30(5): 462-468.
18.	Astephen Wilson JL, Dunbar MJ, Hubley-Kozey CL. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific. J Arthroplasty, 2015, 30(1): 118-125.
19.	Hatfield GL, Hubley-Kozey CL, Astephen Wilson JL, et al. The effect of total knee arthroplasty on knee joint kinematics and kinetics during gait. J Arthroplasty, 2011, 26(2): 309-318.
20.	Orishimo KF, Kremenic IJ, Deshmukh AJ, et al. Does total knee arthroplasty change frontal plane knee biomechanics during gait? Clin Orthop Relat Res, 2012, 470(4): 1171-1176.
21.	Yao ZL, Wang SB, Zhang Y, et al. Clinical significance of novel knee joint stability assessment system for evaluating anterior cruciate ligament deficient knees. Orthop Surg, 2016, 8(1): 75-80.
22.	Kobsar D, Osis ST, Phinyomark A, et al. Reliability of gait analysis using wearable sensors in patients with knee osteoarthritis. J Biomech, 2016, 49(16): 3977-3982.
23.	Astephen JL, Deluzio KJ. Changes in frontal plane dynamics and the loading response phase of the gait cycle are characteristic of severe knee osteoarthritis application of a multidimensional analysis technique. Clin Biomech (Bristol, Avon), 2005, 20 (2): 209-217.

1. Thienpont E, Paternostre F, Pietsch M, et al. Total knee arthroplasty with patient-specific instruments improves function and restores limb alignment in patients with extra-articular deformity. Knee, 2013, 20(6): 407-411.
2. Lustig S, Scholes CJ, Oussedik SI, et al. Unsatisfactory accuracy as determined by computer navigation of VISIONAIRE patient-specific instrumentation for total knee arthroplasty. J Arthroplasty, 2013, 28 (3): 469-473.
3. Victor J, Dujardin J, Vandenneucker H, et al. Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial. Clin Orthop Relat Res, 2014, 472(1): 263-271.
4. MacDessi SJ, Jang B, Harris IA, et al. A comparison of alignment using patient specific guides, computer navigation and conventional instrumentation in total knee arthroplasty. Knee, 2014, 21(2): 406-409.
5. Conteduca F, Iorio R, Mazza D, et al. Are MRI-based, patient matched cutting jigs as accurate as the tibial guides? Int Orthop, 2012, 36 (8): 1589-1593.
6. Malhotra R, Singla A, Lekha C, et al. A prospective randomized study to compare systemic emboli using the computer-assisted and conventional techniques of total knee arthroplasty. J Bone Joint Surg (Am), 2015, 97(11): 889-894.
7. Song IS, Sun DH, Chon JG, et al. Results of revision surgery and causes of unstable total knee arthroplasty. Clin Orthop Surg, 2014, 6(2): 165-172.
8. Schotanus MGM, Schoenmakers DAL, Sollie R, et al. Patient specifc instruments for total knee arthroplasty can accurately predict the component size as used peroperative. Knee Surg Sports Traumatol Arthrosc, 2017, 25(12): 3844-3848.
9. Lachiewicz PF, Henderson RA. Patient-specific instruments for total knee arthroplasty. J Am Acad Orthop Surg, 2013, 21(9): 513-518.
10. 吴东迎, 袁峰, 吴继彬, 等. 3D 打印截骨导板在人工全系关节置换术中的应用. 中华骨科杂志, 2015, 35(9): 921-926.
11. White D, Chelule KL, Seedhom BB. Accuracy of MRI vs CT imaging with particular reference to patient specific templates for total knee replacement surgery. Int J Med Robot, 2008, 4(3): 224-231.
12. Nunley RM, Ellison BS, Ruh EL, et al. Are patient-specific cutting blocks cost-effective for total knee arthroplasty? Clin Orthop Relat Res, 2012, 470(3): 889-894.
13. Cozmei C, Caloian F. Additive manufacturing flickering at the beginning of existence. Procedia Economics and Finance, 2012, 3(12): 457-462.
14. 邱贵兴. 骨关节炎诊治指南 (2007 年版). 中华关节外科杂志 (电子版), 2007, 1(4): 281-285.
15. Slover JD, Rubash HE, Malchau H, et al. Cost-effectiveness analysis of custom total knee cutting blocks. J Arthroplasty, 2012, 27(2): 180-185.
16. de Steiger RN, Liu YL, Graves SE. Computer navigation for total knee arthroplasty reduces revision rate for patients less than sixty-five years of age. J Bone Joint Surg (Am), 2015, 97(8): 635-642.
17. Ullrich B, Stening J, Pelzer T, et al. Long-term data of gait characteristics and moment–knee angle relations in female total knee arthroplasty patients. Clin Biomech (Bristol, Avon), 2015, 30(5): 462-468.
18. Astephen Wilson JL, Dunbar MJ, Hubley-Kozey CL. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific. J Arthroplasty, 2015, 30(1): 118-125.
19. Hatfield GL, Hubley-Kozey CL, Astephen Wilson JL, et al. The effect of total knee arthroplasty on knee joint kinematics and kinetics during gait. J Arthroplasty, 2011, 26(2): 309-318.
20. Orishimo KF, Kremenic IJ, Deshmukh AJ, et al. Does total knee arthroplasty change frontal plane knee biomechanics during gait? Clin Orthop Relat Res, 2012, 470(4): 1171-1176.
21. Yao ZL, Wang SB, Zhang Y, et al. Clinical significance of novel knee joint stability assessment system for evaluating anterior cruciate ligament deficient knees. Orthop Surg, 2016, 8(1): 75-80.
22. Kobsar D, Osis ST, Phinyomark A, et al. Reliability of gait analysis using wearable sensors in patients with knee osteoarthritis. J Biomech, 2016, 49(16): 3977-3982.
23. Astephen JL, Deluzio KJ. Changes in frontal plane dynamics and the loading response phase of the gait cycle are characteristic of severe knee osteoarthritis application of a multidimensional analysis technique. Clin Biomech (Bristol, Avon), 2005, 20 (2): 209-217.

Chinese Journal of Reparative and Reconstructive Surgery

Short-term effectiveness of total knee arthroplasty assisted by three-dimensional printing osteotomy navigation template

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