Application status of open-wedge high tibial osteotomy assisted by three-dimensional printing patient-specific cutting guides_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MA Chi ¹ ,  PIAO Chengzhe ²

1. Graduate School, Shenyang Medical College, Shenyang Liaoning, 110034, P. R. China;
2. Department of First Orthopedics, Affiliated Central Hospital of Shenyang Medical College, Shenyang Liaoning, 110075, P. R. China;

Corresponding author：

PIAO Chengzhe, Email: 25739996@163.com

Keywords：

Open-wedge high tibial osteotomy; three-dimensional printing; patient-specific cutting guides

DOI：

10.7507/1002-1892.202212031

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the application of three-dimensional (3D) printing patient-specific cutting guides (PSCG) in open-wedge high tibial osteotomy (OWHTO). Methods The domestic and foreign literature about the use of 3D printing PSCG to assist the OWHTO in recent years was reviewed, and the effectiveness of different types of 3D printing PSCG to assist OWHTO was summarized. Results Many scholars design and use different 3D printing PSCGs to confirm the precise positioning of the osteotomy site (the bone surface around the cutting line, the “H” point of the proximal tibia, the internal and external malleolus fixators, etc.) and the correction angle (the pre-drilled holes, the wedge-shaped filling blocks, the angle-guided connecting rod, etc.) during operation, and all of them achieve good effectiveness. Conclusion Compared with conventional OWHTO, 3D printing PSCG assisted OWHTO has many obvious advantages, such as shortening the operation time, and the frequency of fluoroscopy, and being closer to the expected preoperative correction, etc. However, the effectiveness between different 3D printing PSCGs still need to be discussed in the follow-up studies.

Citation： MA Chi, PIAO Chengzhe. Application status of open-wedge high tibial osteotomy assisted by three-dimensional printing patient-specific cutting guides. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(3): 360-364. doi: 10.7507/1002-1892.202212031 Copy

1.	Song SJ, Bae DK. Computer-assisted navigation in high tibial osteotomy. Clin Orthop Surg, 2016, 8(4): 349-357.
2.	张军, 张利勇, 宗永刚, 等. 3D打印辅助胫骨截骨治疗膝内侧骨关节炎现状. 中华关节外科杂志 (电子版), 2019, 13(6): 750-754.
3.	Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am, 1979, 10(3): 585-608.
4.	Mao Y, Xiong Y, Li Q, et al. 3D-printed patient-specific instrumentation technique vs. conventional technique in medial open wedge high tibial osteotomy: A prospective comparative study. Biomed Res Int, 2020, 2020: 1923172. doi: 10.1155/2020/1923172.
5.	骆巍, 马信龙, 黄竞敏. 高位胫骨截骨术研究进展. 中国矫形外科杂志, 2018, 26(19): 1786-1789.
6.	Yang JC, Chen CF, Luo CA, et al. Clinical experience using a 3D-printed patient-specific instrument for medial opening wedge high tibial osteotomy. Biomed Res Int, 2018, 2018: 9246529. doi: 10.1155/2018/9246529.
7.	Pérez-Mañanes R, Burró JA, Manaute JR, et al. 3D surgical printing cutting guides for open-wedge high tibial osteotomy: Do it yourself. J Knee Surg, 2016, 29(8): 690-695.
8.	Van Genechten W, Van Tilborg W, Van den Bempt M, et al. Feasibility and 3D planning of a novel patient-specific instrumentation technique in medial opening-wedge high tibial osteotomy. J Knee Surg, 2021, 34(14): 1560-1569.
9.	Chernchujit B, Tharakulphan S, Prasetia R, et al. Preoperative planning of medial opening wedge high tibial osteotomy using 3D computer-aided design weight-bearing simulated guidance: Technique and preliminary result. J Orthop Surg (Hong Kong), 2019, 27(1): 2309499019831455. doi: 10.1177/2309499019831455.
10.	Munier M, Donnez M, Ollivier M, et al. Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? Pilot study Orthop Traumatol Surg Res, 2017, 103(2): 245-250.
11.	Abdullah KA, Reed W. 3D printing in medical imaging and healthcare services. J Med Radiat Sci, 2018, 65(3): 237-239.
12.	Marro A, Bandukwala T, Mak W. Three-dimensional printing and medical imaging: A review of the methods and applications. Curr Probl Diagn Radiol, 2016, 45(1): 2-9.
13.	Han SB, Lee DH, Shetty GM, et al. A “safe zone” in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 90-95.
14.	Jörgens M, Keppler AM, Ahrens P, et al. 3D osteotomies-improved accuracy with patient-specific instruments (PSI). Eur J Trauma Emerg Surg, 2022. doi: 10.1007/s00068-022-02060-4.
15.	Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
16.	高发维, 王成功, 胡懿郃, 等. 分体式3D打印个性化导板在内侧开放楔形胫骨高位截骨术中的临床应用. 中国修复重建外科杂志, 2021, 35(9): 1119-1124.
17.	刘国彬, 刘森, 王立飞, 等. 3D打印个性化截骨辅助模块在胫骨高位截骨术中的应用进展. 实用骨科杂志, 2022, 28(4): 328-332.
18.	Miao Z, Li S, Luo D, et al. The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study. J Orthop Surg Res, 2022, 17(1): 62. doi: 10.1186/s13018-022-02956-2.
19.	Jones GG, Jaere M, Clarke S, et al. 3D printing and high tibial osteotomy. EFORT Open Rev, 2018, 3(5): 254-259.
20.	刘国彬, 刘森, 王立飞, 等. 一种基于 “H” 点的全新3D打印个性化截骨导板辅助胫骨高位截骨术的尸体研究. 实用骨科杂志, 2021, 27(10): 941-946, 950.
21.	Liu GB, Liu S, Zhu CH, et al. A novel 3D-printed patient-specific instrument based on “H-point” for medial opening wedge high tibial osteotomy: a cadaver study. J Orthop Surg Res, 2022, 17(1): 169. doi: 10.1186/s13018-022-03057-w.
22.	王兴山, 黄野, 柳剑, 等. 3D打印截骨导板辅助胫骨高位截骨术的准确性和安全性研究. 实用骨科杂志, 2021, 27(10): 865-869.
23.	柳剑, 李兵, 王兴山, 等. TomoFix3D打印导板在胫骨高位截骨术中的应用方法. 实用骨科杂志, 2021, 27(10): 955-957.
24.	Jud L, Fürnstahl P, Vlachopoulos L, et al. Malpositioning of patient-specific instruments within the possible degrees of freedom in high-tibial osteotomy has no considerable influence on mechanical leg axis correction. Knee Surg Sports Traumatol Arthrosc, 2020, 28(5): 1356-1364.
25.	Ozel O, Yucel B, Mutlu S, et al. Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc, 2017, 25(1): 314-318.
26.	Jo HS, Park JS, Byun JH, et al. The effects of different hinge positions on posterior tibial slope in medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1851-1858.
27.	Victor J, Premanathan A. Virtual 3D planning and patient specific surgical guides for osteotomies around the knee: a feasibility and proof-of-concept study. Bone Joint J, 2013, 95-B(11 Suppl A): 153-158.
28.	Predescu V, Grosu AM, Gherman I, et al. Early experience using patient-specific instrumentation in opening wedge high tibial osteotomy. Int Orthop, 2021, 45(6): 1509-1515.
29.	Chaouche S, Jacquet C, Fabre-Aubrespy M, et al. Patient-specific cutting guides for open-wedge high tibial osteotomy: safety and accuracy analysis of a hundred patients continuous cohort. Int Orthop, 2019, 43(12): 2757-2765.
30.	Kim HJ, Park J, Park KH, et al. Evaluation of accuracy of a three-dimensional printed model in open-wedge high tibial osteotomy. J Knee Surg, 2019, 32(9): 841-846.
31.	赵大鹏, 宫林海, 张晓涛, 等. 3D打印截骨模具辅助下开放楔形胫骨高位截骨术治疗内翻性膝骨关节炎早期疗效分析. 中国现代手术学杂志, 2019, 23(5): 338-344.
32.	李小兵, 郭新军, 冯立平, 等. 3D打印辅助高位胫骨截骨治疗内侧室膝骨关节炎. 中国矫形外科杂志, 2021, 29(21): 1950-1954.
33.	张利勇, 万春飞, 张军, 等. 3D打印个体化截骨导板辅助胫骨高位截骨术治疗内翻型膝骨关节炎精准性的临床疗效. 中国临床医学, 2021, 28(4): 646-651.

1. Song SJ, Bae DK. Computer-assisted navigation in high tibial osteotomy. Clin Orthop Surg, 2016, 8(4): 349-357.
2. 张军, 张利勇, 宗永刚, 等. 3D打印辅助胫骨截骨治疗膝内侧骨关节炎现状. 中华关节外科杂志 (电子版), 2019, 13(6): 750-754.
3. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am, 1979, 10(3): 585-608.
4. Mao Y, Xiong Y, Li Q, et al. 3D-printed patient-specific instrumentation technique vs. conventional technique in medial open wedge high tibial osteotomy: A prospective comparative study. Biomed Res Int, 2020, 2020: 1923172. doi: 10.1155/2020/1923172.
5. 骆巍, 马信龙, 黄竞敏. 高位胫骨截骨术研究进展. 中国矫形外科杂志, 2018, 26(19): 1786-1789.
6. Yang JC, Chen CF, Luo CA, et al. Clinical experience using a 3D-printed patient-specific instrument for medial opening wedge high tibial osteotomy. Biomed Res Int, 2018, 2018: 9246529. doi: 10.1155/2018/9246529.
7. Pérez-Mañanes R, Burró JA, Manaute JR, et al. 3D surgical printing cutting guides for open-wedge high tibial osteotomy: Do it yourself. J Knee Surg, 2016, 29(8): 690-695.
8. Van Genechten W, Van Tilborg W, Van den Bempt M, et al. Feasibility and 3D planning of a novel patient-specific instrumentation technique in medial opening-wedge high tibial osteotomy. J Knee Surg, 2021, 34(14): 1560-1569.
9. Chernchujit B, Tharakulphan S, Prasetia R, et al. Preoperative planning of medial opening wedge high tibial osteotomy using 3D computer-aided design weight-bearing simulated guidance: Technique and preliminary result. J Orthop Surg (Hong Kong), 2019, 27(1): 2309499019831455. doi: 10.1177/2309499019831455.
10. Munier M, Donnez M, Ollivier M, et al. Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? Pilot study Orthop Traumatol Surg Res, 2017, 103(2): 245-250.
11. Abdullah KA, Reed W. 3D printing in medical imaging and healthcare services. J Med Radiat Sci, 2018, 65(3): 237-239.
12. Marro A, Bandukwala T, Mak W. Three-dimensional printing and medical imaging: A review of the methods and applications. Curr Probl Diagn Radiol, 2016, 45(1): 2-9.
13. Han SB, Lee DH, Shetty GM, et al. A “safe zone” in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 90-95.
14. Jörgens M, Keppler AM, Ahrens P, et al. 3D osteotomies-improved accuracy with patient-specific instruments (PSI). Eur J Trauma Emerg Surg, 2022. doi: 10.1007/s00068-022-02060-4.
15. Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
16. 高发维, 王成功, 胡懿郃, 等. 分体式3D打印个性化导板在内侧开放楔形胫骨高位截骨术中的临床应用. 中国修复重建外科杂志, 2021, 35(9): 1119-1124.
17. 刘国彬, 刘森, 王立飞, 等. 3D打印个性化截骨辅助模块在胫骨高位截骨术中的应用进展. 实用骨科杂志, 2022, 28(4): 328-332.
18. Miao Z, Li S, Luo D, et al. The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study. J Orthop Surg Res, 2022, 17(1): 62. doi: 10.1186/s13018-022-02956-2.
19. Jones GG, Jaere M, Clarke S, et al. 3D printing and high tibial osteotomy. EFORT Open Rev, 2018, 3(5): 254-259.
20. 刘国彬, 刘森, 王立飞, 等. 一种基于 “H” 点的全新3D打印个性化截骨导板辅助胫骨高位截骨术的尸体研究. 实用骨科杂志, 2021, 27(10): 941-946, 950.
21. Liu GB, Liu S, Zhu CH, et al. A novel 3D-printed patient-specific instrument based on “H-point” for medial opening wedge high tibial osteotomy: a cadaver study. J Orthop Surg Res, 2022, 17(1): 169. doi: 10.1186/s13018-022-03057-w.
22. 王兴山, 黄野, 柳剑, 等. 3D打印截骨导板辅助胫骨高位截骨术的准确性和安全性研究. 实用骨科杂志, 2021, 27(10): 865-869.
23. 柳剑, 李兵, 王兴山, 等. TomoFix3D打印导板在胫骨高位截骨术中的应用方法. 实用骨科杂志, 2021, 27(10): 955-957.
24. Jud L, Fürnstahl P, Vlachopoulos L, et al. Malpositioning of patient-specific instruments within the possible degrees of freedom in high-tibial osteotomy has no considerable influence on mechanical leg axis correction. Knee Surg Sports Traumatol Arthrosc, 2020, 28(5): 1356-1364.
25. Ozel O, Yucel B, Mutlu S, et al. Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc, 2017, 25(1): 314-318.
26. Jo HS, Park JS, Byun JH, et al. The effects of different hinge positions on posterior tibial slope in medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1851-1858.
27. Victor J, Premanathan A. Virtual 3D planning and patient specific surgical guides for osteotomies around the knee: a feasibility and proof-of-concept study. Bone Joint J, 2013, 95-B(11 Suppl A): 153-158.
28. Predescu V, Grosu AM, Gherman I, et al. Early experience using patient-specific instrumentation in opening wedge high tibial osteotomy. Int Orthop, 2021, 45(6): 1509-1515.
29. Chaouche S, Jacquet C, Fabre-Aubrespy M, et al. Patient-specific cutting guides for open-wedge high tibial osteotomy: safety and accuracy analysis of a hundred patients continuous cohort. Int Orthop, 2019, 43(12): 2757-2765.
30. Kim HJ, Park J, Park KH, et al. Evaluation of accuracy of a three-dimensional printed model in open-wedge high tibial osteotomy. J Knee Surg, 2019, 32(9): 841-846.
31. 赵大鹏, 宫林海, 张晓涛, 等. 3D打印截骨模具辅助下开放楔形胫骨高位截骨术治疗内翻性膝骨关节炎早期疗效分析. 中国现代手术学杂志, 2019, 23(5): 338-344.
32. 李小兵, 郭新军, 冯立平, 等. 3D打印辅助高位胫骨截骨治疗内侧室膝骨关节炎. 中国矫形外科杂志, 2021, 29(21): 1950-1954.
33. 张利勇, 万春飞, 张军, 等. 3D打印个体化截骨导板辅助胫骨高位截骨术治疗内翻型膝骨关节炎精准性的临床疗效. 中国临床医学, 2021, 28(4): 646-651.

Chinese Journal of Reparative and Reconstructive Surgery

Application status of open-wedge high tibial osteotomy assisted by three-dimensional printing patient-specific cutting guides

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