Three-dimensional CT Reconstruction In Total Knee Arthroplasty In Individual Applications

Objective:To explore the advantages in the reconstruction of lower limb alignment, positioning osteotomy and prosthesis using three-dimensional CT reconstruction techniques to develop individualized knee model. Contrasting the preoperative and postoperative score to analyze the clinical effects of three-dimensional reconstruction technique applied in individualized knee, which aimed to guide the individualized knee replacement surgery.Method:Evaluate the operative risk, do CT-scan of lower limbs to complete the three-dimensional modeling of the lower limbs. Basis on the data, develop a personalized positioning osteotomy, which can help to obtain the best line of force of the lower limbs reconstruction, osteotomy parameters and placement angle of prosthesis. Apply the data into the following surgical operation, guide the patient to do postoperative rehabilitation training and prevent complications. Get the hip-knee-ankle angle and HSS on the second week before and after the operation, calculate the excellent rate. According statistical analysis, evaluate the recovery of limb alignment and function of the knee, which can evaluate the accuracy of the parameter of three-dimensional reconstruction and the surgical treatment. According the above analysis, summary the advantages of application of three-dimensional reconstruction into the operation of total knee replacement.Result:We successfully do total knee arthroplasty surgery tothe enrolled11patients, and achieved satisfactory result. The limb alignment angle before the surgery is8.1482°±1.5957°. and after surgery is1.0627°±0.6401°. Paired T-test was used in analyzing the data of limb alignment angle. The T is13.6683, P<0.001, which has statistically significant. Lower limb alignment of the patient after surgery is close to the ideal force. HSS score improved from49.6±6.1, before surgery to88.2±4.1two weeks after surgery. It has statistically significant (P<0.05). In HSS evaluation after surgery there are8excellent cases,2good,1ok,0bad. The rate is90.9%.Conclusion:Three-dimensional reconstruction before surgery has obvious advantages. Using CT data, measuring key parameters, making plan are good to reconstruct limb alignment correctly, position osteotomy accurately and implant prosthesis. After surgery the function of the limb gets recovery well. The patients get high HSS score. Limb alignment gets better. The application of three-dimensional reconstruction into TKR can reduce surgical error, improve surgical precision and clinical outcomes and increase the satisfaction of the patients.