A Comparative Study On The Effect Of 3D Printing Osteotomy Guide In Total Knee Arthroplasty And Traditional Total Knee Arthroplasty

Objective: To compare the clinical effect of total knee arthroplasty with traditional total knee arthroplasty by using 3D printing personalized osteotomy guide.Methods: 30 patients who received total knee arthroplasty(TKA)from September 2018 to September 2019 were collected.Randomly divided into two groups,each group 15 cases of knee replacement,two groups of surgeons for the same person.The experimental group was treated with3 D printing personalized osteotomy guide assisted with total knee arthroplasty,while the control group was treated with traditional total knee arthroplasty.The operation time,intraoperative blood loss,total blood loss(intraoperative blood loss + occult blood loss),the number of patients with MFT greater than 4°and the pain visual analogue score(VAS)and the knee joint score(HSS)of American special surgical hospital were recorded as the main evaluation indexes.In addition,ldfa,MFTA,STCA,MPTA wereselectedas the imagingevaluationindexesof postoperativeeffect.Results: the operation time of 3D printing personalized osteotomy guide group was significantly shorter than that of traditional total knee replacement group,and the difference between the two groups was statistically significant(t =-6.43 P = 0.000);the amount of bleeding in3 D printing personalized osteotomy guide group was significantly less than that in traditional total knee replacement group,and the differencebetweenthe two groups was statisticallysignificant(t =-7.12)P = 0.000);the total blood loss(intraoperative blood loss + invisible blood loss)of 3D printing personalized osteotomy guide group was significantly less than that of traditional total knee arthroplasty group,and the differencebetween the two groups was statistically significant(t=-8.16 P = 0.000);the difference between 3D printing personalized osteotomy guide group and traditional total knee arthroplasty group was not statistically significant(t = 23 P = 0.792);there was no significant difference in vas between the two groups on the 1st,7th,14 th and 30 th day after operation,but the HSS score of 3D printing personalized osteotomy guide group was significantly better than that of traditional total knee replacement group on the 1st and 7th day(t =-6.62)P =0.000),but there was no significant difference between the two groups in the HSS score of 14 d and30d;the MFT of the 3D printing personalized osteotomy guide group was higher than that of the traditional total knee arthroplasty group(t =-2.562,P = 0.020);the difference between the 3D printing personalized osteotomy guide group and the traditional total knee arthroplasty group in the ldfa angle,MFTA angle,STCA angle and MPTA angle after operationwas statistically significant(t =-2.562,P = 0.020);the difference between the 3D printing personalized osteotomy guide group and the traditional total knee arthroplasty group was statistically significant All of them were small and not statisticallysignificant.Conclusion: 3D printing osteotomy guide plate technology has the advantages of precise measurement,precise positioning,precise placement and individual design.It improves the accuracy of prosthesis placement,simplifies the operation procedure,shortens the operation time and avoids femoral open pulp,so it also reduces intraoperative and postoperative invisible bleeding.The results showed that the difference rate of the lower limb force line greater than 4 ° was significantly lower in the patients with 3D printing osteotomy guide than in the patients with TKA,and there was no significant difference in other angle parameters.Compared with traditional total knee arthroplasty,3D printing osteotomy guide assisted total knee arthroplasty has obvious advantages in the short-term recovery of knee joint function,but there is no significant difference in the long-term effect.The 3D printing osteotomy guide group had no significant advantage in VAS pain score in the short term or long term.Therefore,the application of 3D printing osteotomy guide in total knee arthroplasty can improve the operation accuracy,reduce the bleeding and improve the knee jointfunction in a shorttime.