Clinical Analysis Of A 3D-printed Technique For Medial Opening Wedge High Tibial Osteotomy Combined With Arthroscopy In The Treatment Of Knee Varus Deformity

Objective: With the revival of the concept of knee-protection,traditional osteotomy has been given more attention and development,and more precise osteotomy has become a research hotspot.High tibial osteotomy is one of the most effective methods for treating medial compartment osteoarthritis with varus deformity.However,traditional osteotomy has difficulty in controlling the accuracy of osteotomy,requires multiple perspectives during the operation,long operation time and radiation large amount of disadvantages.observation of orthopedic accuracy and clinical efficacy of 3D printed osteotomy guide plate assisted with Medial Opening Wedge High Tibial Osteotomy combined with arthroscopic debridement for knee varus deformity.Methods:Retrospective analysis of thirty knees varus deformity in the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from January 2017 to May 2018.In combination with the 3D printing model technology,then open wedge HTO was performed,According to the ideal weight-bearing line,the osteotomy site,cutting point,lateral hinge,sawing direction,sawing depth,and tibial slope were determined.Then the preoperative Fujisawa point,Lysholm score,tibial slope,and Caton index,were compared with postoperative.Results: Arthroscopically,2 knees were found with meniscus injury,and meniscectomy was performed.One case had cartilage exfoliation,which was cleaned and fresh,and no microfracture treatment was performed.After 15 to 24 months of follow-up,the VAS score decreased by 2-5 points after one year operation,and both improved significantly.The WBL recovered from preoperative 18.03±1.08% to60.03±0.64%(p<0.05).The difference was statistically significant.The 3D print design Fujisawa point was 61.05±0.44%,which was not statistically different from postoperative(p<0.05),the anterior-posterior error was about1.023±0.78%;the tibial slope of pre-and postoperative was respectively9.96±0.16°,10.00± 0.08°(p>0.05);The Lysholm score of 1 year after operation was 82.20±0.82,the difference was statistically significant to the preoperative(34.80±1.33)points.Conclusion: a 3D-Printed technique for Medial Opening Wedge High Tibial Osteotomy Combined with Arthroscopy can achieve accurate osteotomy can significantly improve the weight-bearing line,reduce intraoperative perspective,save operation time,achieve a certain degree of precision medical treatment,is a safe and effective treatment of knee inversion Treatment,but the long-term efficacy needs to be followed up,and arthroscopic exploration is necessary.