Application And Research Of Digital Knee Joint Assisted Systems In Total Knee Arthroplasty

Objective To investigate the application and progress of digital knee joint assisted systems in Total Knee Arthroplasty.Compare different techniques and variations in designing 3D printing personal specific instrument(PSI)assisted TKA,and then compare its clinic results with iASSIST assisted total knee arthroplasty(TKA)in the treatment of osteoarthritis(OA).Methods Investigate the simulation and design of TKA under the background of digital medicine,combine modern imaging and image processing with orthopedics,bring up a new method based on centroid principle beyond anatomical marks for locating the lower limb during the PSI design process,study the objective and precise positioning of the lower axis in three-dimensional space to design the personalized osteotomy guide plate.We adopted retrospective analysis,90 patients with osteoarthritis(OA)were treated with TKA between January 2016 to Sep 2016(including 36 males and 54 females,ranging from 49 to 88 with the mean age of 69.6±7.7.They were randomly divided into conventional-TKA group(29 patients),iASSIST-TKA group(30 patients)and PSI-TKA group(31 patients),no significance were found between the two groups.All HKA,FFC,FTC,LFF,LTC angles,time of operation,post-operative wound drainage,period of hospitalization,VAS and KSS scores at 1 day,1 week,2 weeks,1 month,3months and 6 months were recorded and compared within the three groups.Results The new centroid method which could locate the lower limb line showed better and more accurate results in design PSI.No significant difference were observed between the average difference-value of HKA,FFC,LFC,FTC and LTC at iASSIST-TKA group and PSI-TKA group(Z=-1.78?0,P=0.43?1).There was no significant difference in the offset values between the two groups(Z=-1.78-0,P=0.43?1).The two groups showed no significant difference intra-operative blood drainage(t=8.29,P=0.00)and the period of hospitalization(t=0.65,P=0.515).PSI-TKA group had shorter time of operation(t=15.5,P=0.00)and a smaller amount of post-operative wound drainage(t=8.29,P=0.00).PSI-TKA group had a superior VAS and KSS score of 1 day and 1 week post operation(t=-11?7.25,P=0.00?0.96).When compared with the conventional group,they all showed significant difference among the three(t=7.73?56.81,P=0.00?0.02).Three groups showed no significant difference in VAS and KSS score of 2 weeks,1 month,3 months and 6 months post-operatively(t=-1.22-3.23,P=0.05?0.30).Conclusion The new centroid method indicated greater and more accurate results,it also had better postoperative outcomes,which could set as a standard for locating the lower limb line.The iASSIST-TKA and PSI-TKA both have advantages and disadvantages and may both help to make TKA procedure more accurately.The iASSIST-TKA may take a longer time of operation and have a slower recovery,PSI-TKA may need more X-ray input and a longer period of hospitalization.