| ObjectiveTo observe the early clinical outcome of 3D printing osteotomy navigation template assisted total knee arthroplasty and analysis knee joint kinematics.Method60 patients who were dignosised knee osteoarthritis and accepted total knee arthroplasty(TKA)in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from January 2016 to June 2017 were collected.The patients:included 23 males and 37 females,the average age was(65.76±6.32)years,the average BMI was(24.48 ±0.76).The patients were divided into 3D printing group(30 cases who were operated by 3D printing osteotomy navigation template assisted total knee arthroplasty),and conventional TKA group(30 cases who were operated by conventional TKA).All patients were followed up for clinical follow-up,three dimensional digital measurement and knee joint kinematics.Then compare two groups in early clinical outcome,three dimensional digital measurement.Finally,compare knee joint kinematics data among 3D group,conventional TKA group and healthy adults.ResultsThere was no significant difference in age,BMI between the two groups(P>0.05).The operation time of 3D printing group was shorter than the conventional TKA group(P<0.05).The hemoglobin values of postoperation at 1st and 3rd day of 3D printing group were higher than conventional TKA group(P<0.05).The amount of postoperation drainage of 3D printing group were less than the conventional TKA group(P<0.05).There was no significant difference on HSS,KSS(clinical score)preoperation and at 6th month postoperation and KSS(function score)preoperation between the two groups(P?0.05).The KSS function score of 3D printing group at 6th month postoperation were higher than the conventional TKA group(P<0.05).There was no significant difference in tibial platform inversion angle between conventional TKA group postoperation and standard value of normal Chinese people(P ? 0.05),but the hip-knee-ankle angle of conventional TKA group postoperation was smaller than standard value of normal Chinese people(P<0.05),the tibial platform posterior inclination angle was bigger than standard value of normal Chinese people(P<0.05).There was no significant difference in postoperative tibial platform inversion angle between 3D group and conventional TKA group(P?0.05),but the angle of 3D group was bigger than conventional TKA group,much more close to standard value of normal Chinese people(P<0.05).The postoperative tibial platform posterior inclination angle of 3D group was smaller than conventional TKA group,but it was much more close to standard value of normal Chinese people(P<0.05).After comparison we can find:at preoperation,the varus and valgus angle,the internal and external rotation angle,the antero-posterior displacement,the proximal-distal displacement of the 3D printing group and the conventional TKA group were larger than the healthy adults(P<0.05).At postoperation,there was no difference in the varus and valgus angle between the 3D printing group and the healthy adults(P?0.05),but the conventional TKA group was larger than the healthy adults(P<0.05);There was no difference in the flexion and extension angle between the 3D printing group and the healthy adults(P?0.05),but the conventional TKA group was less than the healthy adults(P<0.05);The proximal-distal displacement,the internal and external displacement of the 3D group and the conventional TKA group were less than the healthy audlts(P<0.05).Conclusion3D printing osteotomy navigation template assisted total knee arthroplasty and conventinal TKA can both get satisfied early clinial outcome postoperation,but 3D printing osteotomy navigation template assisted total knee arthroplasty can get better advantages in knee morphology and knee joint kinematics.Part One Early clinical outcome analysis of 3D printing osteotomy navigation template assisted total knee arthroplasty versus conventional total knee arthroplastyObjectiveTo observe the early clinical outcome between 3D printing osteotomy navigation template assisted total knee arthroplasty and conventional total knee arthroplasty.Method60 patients who were dignosised knee osteoarthritis and accepted total knee arthroplasty(TKA)in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from January 2016 to June 2017 were collected.The patient included 23 males and 37 females,the average age was(65.76±6.32)years,the average BMI was(24.48±0.76).The operation time,the hemoglobin values of preoperation and postoperation at 1st and 3rd day,the amount of postoperation drainage,the HSS score and KSS score of knee joint preoperation and postoperation at 3rd month were observed between 3D printing group and conventional TKA group.ResultsThere was no significant difference in age,BMI between the two groups(P>0.05).The operation time of 3D printing group was shorter than that of conventional TKA group(P<0.05).The hemoglobin values of postoperation at 1st and 3rd day of 3D printing group were higher than that of conventional TKA group(P<0.05).The amount of postoperation drainage of 3D printing group was less than that of conventional TKA group(P<0.05).There was no significant difference on HSS,KSS(clinical score)preoperation and at 6th month postoperation and KSS(function score)preoperation between the two groups(P?0.05).The KSS function scores of 3D printing group at 6th month postoperation were higher than that of conventional TKA group(P<0.05).ConclusionCompared with the traditional TKA,3D printing osteotomy navigation template assisted total knee arthroplasty had some advantages of shorter operative time,less bleeding,well postoperative recovery.It had better prospects for development.Part Two Comparison analysis of three-dimensional digital measurement between 3D printing osteotomy navigation template assisted total knee arthroplasty and conventional total knee arthroplastyObjectiveTo construct the three-dimensional model of lower limbs between 3D group and conventional TKA group of preoperation and postoperation,and compare the data of two groups.Method60 patients who were dignosised knee osteoarthritis and accepted total knee arthroplasty(TKA)in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from January 2016 to June 2017 were collected.The patients included 23 males and 37 females,the average age was(65.76± 6.32)years,the average BMI was(24.48 ± 0.76).The patients were divided into 3D printing group(30 cases)and conventional TKA group(30 cases).The image data of all both lower limb were collected by CT scaning preoperation and postoperation.The CT data were imported into Mimics 17.0 software in DICOM format,and three dimensional digital model of lower limbs were constructioned.The corresponding knee joint prostheses were selected and gotten 3D laser scan and reconstructed 3D models.Then the 3D models of prostheses were fitted to knee joint models by point-to-point registering technology with Mimics 17.0 software.After three dimensional reconstruction,the models of two groups were measured by Mimics 17.0 software,included hip-knee-ankle angle,tibial platform inversion angle and tibial platform posterior inclination angle.The results were compared between groups,and both compared with the standard value of normal Chinese people at the same time.ResultsComparison of preoperative and postoperative measurement values between 3D printing group and traditional TKA group,the hip-knee-ankle angle,the tibial platform inversion angle and the tibial platform posterior inclination angle were different between two groups(P<0.05).There was no significant difference in hip-knee-ankle angle,tibial platform inversion angle and tibial platform posterior inclination angle between 3D group postoperation and that of normal Chinese people(P?0.05).There was no significant difference in tibial platform inversion angle between conventional TKA group postoperation and that of normal Chinese people(P ? 0.05),but the hip-knee-ankle angle of conventional TKA group postoperation was smaller than that of normal Chinese people(P<0.05),the tibial platform posterior inclination angle was bigger than that of normal Chinese people(P<0.05).There was no significant difference in postoperative tibial platform inversion angle between 3D group and that of conventional TKA group(P?0.05),but the angle of 3D group was bigger than that of conventional TKA group,much more close to that of normal Chinese people(P<0.05).The postoperative tibial platform posterior inclination angle of 3D group was smaller than that of conventional TKA group,but it was much more close to that of normal Chinese people(P<0.05).ConclusionCompared with conventional TKA,3D printing osteotomy navigation template assisted total knee arthroplasty could get much more satisfied lower limb alignment,provided a good foundation for rapid postoperative recovery and reduction of postoperative revision rates.Part Three The knee joint kinematics analysis between 3D printing osteotomy navigation template assisted total knee arthroplasty and conventional total knee arthroplastyObjectiveTo analyze the knee joint kinematics data of ipsilateral knee joint between 3D printing group and conventional TKA group at preopration and 6th month postopration.Method60 patients who were dignosed knee osteoarthritis and accepted total knee arthroplasty(TKA)in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from January 2016 to June 2017 were collected.The patients were divided into 3D printing group(30 cases)and conventional TKA group(30 cases).30 healthy audlts knee joint kinematics data were collected.The knee joint kinematics data of ipsilateral knee joint between 3D printing group and conventional TKA group at preopration and 6th month postopration were recorded.6 freedom degrees data of knee(the varus and valgus angle,the internal and external rotation angle,the flexion and extension angle and the internal,the antero-posterior displacement,the proximal-distal displacement and internal and External displacement)among the 3D group,the conventional TKA group and healthy audlt group were compared.ResultsAt preoperation,the varus and valgus angle,the internal and external rotation angle,the antero-posterior displacement,the proximal-distal displacement of the 3D printing group and that of conventional TKA group were larger than that of healthy adults(P<0.05).At postoperation,there was no difference in the varus and valgus angle between the 3D printing group and the healthy adults(P?0.05),but the conventional TKA group was larger than the healthy adults(P<0.05);There was no difference in the flexion and extension angle between the 3D printing group and the healthy adults(P?0.05),but the conventional TKA group was less than that of healthy adults(P<0.05);The proximal-distal displacement,the internal and external displacement of the 3D group and the conventional TKA group were less than that of healthy audits(P<0.05).Conclusions1.Compared with conventional total knee arthroplasty,3D printing osteotomy navigation template assisted total knee arthroplasty could get more satisfied with early knee function recovery.2.Knee joint kinematics analysis could assess the situation of the knee movements more objectively at preoperation and postoperation.It showed greater instruction for clinical outcomes. |
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