Design And Manufacture Of 3D Print Osteotomy Guider For Total Knee Joint Replacement Based On Quick Reverse Engineering

Objective: To design and manufacture a total knee arthroplasty osteotomy guider using rapid reverse technique and 3D printing technique,and to study its clinical application.Methods: The three-dimensional white photographic scanner was used to rapidly reverse the knee replacement prosthesis and establish the prosthesis database.Ten patients undergoing total knee arthroplasty in our hospital from December 2015 to October 2017 were selected.Preoperative patients underwent dual-source CT scans ranging from hip joints to ankle joints.Medical engineering software was used to reconstruct three-dimensional bones.model.In the three-dimensional view using engineering modeling software to determine the force line of the lower limbs,which were individually designed individualized femur,tibial osteotomy guide.Preoperative simulation of surgical operation,using a 3D printer to create a bone model and osteotomy guide,intraoperative osteotomy guide osteotomy surgery operation,placement of knee prosthesis.The X-rays of the knee joints were reviewed postoperatively to evaluate the force lines of the lower extremities.The scores of the Hospital for Special Surgery(HSS)and the range of motion(ROM)were recorded 6 weeks after operation.Results: A preliminary database of digital in-vivo plant models was established,which can be used for digital pre-operative design,and the prosthesis size was determined.All patients included in the study successfully performed individualized knee replacement surgery,and the prosthesis was well-placed,with joint space and knee joints.The valgus deformity was corrected.The post-operative measurement of the lower limbs' line of force:(1.93°±0.31°),the HSS score at 6 weeks postoperatively was(86.2±2.53)points,and ROM of the joint activity was 101.7°±2.54°.Patients were resumed satisfaction with knee mobility and normal lower extremity force line.Conclusion:Computer-aided design of 3D-printed osteotomy guide can be customized surgical procedures before surgery to simplify the surgical procedures to obtain a good lower limb force lines and surgical results.