Application Of 3D Pringting Technology In The Localization Of Lateral Femoral Bone Tunnel During Anterior Cruciate Ligment Reconstruction

[objective]To explore the value of 3D printing technology in the localization of femoral bone tunnel during anterior cruciate ligament(ACL)reconstruction under knee arthroscopy and to evaluate the postoperative curative effect.[methods]Twenty patients with ACL injury diagnosed in The First People's Hospital of Chenzhou from December 2017 to August 2019 were randomly divided into two groups: 3D group(n = 10)and traditional operation group(n = 10).There were five males and five females in 3D group,with an average age of 39.500 ±9.560 years.The lateral tibial tunnel was located with traditional guiding device,and the lateral femoral tunnel was located by printing knee joint model and femoral lateral guide plate according to the CT and MRI data of knee joint.In the traditional operation group,there were four males and six females with an average age of 34.300±12.410.The traditional method of ACL reconstruction through tibial tunnel was used to locate the entrance of femoral and tibial tunnel under arthroscopy.The end of tibia tunnel was fixed with hydroxyapatite squeeze screw and microporous plate(Endobutton,UK,Smith&Nephew)was applied at the end of femoral tunnel.X-ray examination of knee joint were conducted routinely,and the position of the femoral tunnel was evaluated by Amis measurement.The average follow-up of the two groups was 6 months.The range of motion(ROM)of knee joint and postoperative complications were recorded before and six months after operation.The Lysholm score of affected knee joint before operation and six months after operation were evaluated,and then the results were statistically ananlyzed.[results]The average values of femoral tunnel position in 3D group and traditional operation group were(46.160±2.078)% and(42.240±1.560)%,respectively.The difference was statistically significant(all P<0.05).The Lysholm score increased from 63.230±4.450 to 95.380±2.169 in 3D group,from 62.440±4.135 to 95.860±1.991 in traditional operation group.There was no significant difference in postoperative Lysholm score between two groups(P>0.05).The ROM of knee joint increased from(90.300±13.191)°to(119.200±7.436)°after operation in 3D group,and from(89.400 ±7.633)°to(118.700±6.584)°in traditional operation group.There was no significant difference in the ROM of knee joint between two groups(P>0.05).There were no postoperative complications in both groups.[conclusion]Compared with the traditional localization methods,the 3D printing-assisted femoral bone tunnel localization has the advantages of individualization and precision,but the clinical effect neeeds to be further verified by long-term follow-up.