Clinical Application Of 3D Simulation Printing Technology In Complex Total Knee Arthroplasty

Objective:To establish the preoperative plan of complex TKA by 3D simulation printing technology,and to explore the short-term clinical efficacy.Methods: 43 cases of knee osteoarthritis with severe varus deformity and tibial plateau defect were randomly divided into two groups from November 2017 to June 2019.There were 21 cases in 3D printing group and 22 cases in routine group.The 3D printing group imported 3D CT data into Mimics software in DICOM format to establish a 3D data model of knee joint.Import the 3d model into the 3D ACT ITI technology platform developed by aikang company.Then the prosthesis model and osteotomy instrument model are introduced,and the operation is simulated preoperatively according to the reference data to adjust the optimal position of the implanted prosthesis.Determine the type and size of the prosthesis used during the operation,formulate the operation plan,and install the prosthesis according to the simulated operation procedures during the operation without repeated measurement.Routine group was performed according to routine TKA.The operation time,intraoperative hemorrhage,postoperative drainage volume,mechanical axis angle between femur and tibia 3 months after operation,VAS score 2 weeks after operation and KSS score 3 months after operation were compared between the two groups.Results:The research data showed that the operation time,intraoperative hemorrhage and postoperative drainage in the 3D printing group were less than those in the conventional group,with statistical significance(P < 0.05).The VAS score at 2 weeks after operation and the clinical KSS score at 3 months after operation in the 3D printing group were better than those in the conventional group,with statistical significance(p < 0.05).The functional KSS score and the angle between femoral and tibial mechanical axes in the 3-D printing group had no statistical significance compared with the conventional group(P>0.05).Conclusion:The application of 3D simulation printing technology in complex TKA can reduce the operation time and intraoperative bleeding,and patients can obtain better knee joint function and clinical effect.