Application status of open-wedge high tibial osteotomy assisted by three-dimensional printing patient-specific cutting guides_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MA Chi ¹ ,  PIAO Chengzhe ²

1. Graduate School, Shenyang Medical College, Shenyang Liaoning, 110034, P. R. China;
2. Department of First Orthopedics, Affiliated Central Hospital of Shenyang Medical College, Shenyang Liaoning, 110075, P. R. China;

Corresponding?author：

PIAO Chengzhe, Email: 25739996@163.com

Keywords：

Open-wedge high tibial osteotomy; three-dimensional printing; patient-specific cutting guides

DOI：

10.7507/1002-1892.202212031

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the application of three-dimensional (3D) printing patient-specific cutting guides (PSCG) in open-wedge high tibial osteotomy (OWHTO). Methods The domestic and foreign literature about the use of 3D printing PSCG to assist the OWHTO in recent years was reviewed, and the effectiveness of different types of 3D printing PSCG to assist OWHTO was summarized. Results Many scholars design and use different 3D printing PSCGs to confirm the precise positioning of the osteotomy site (the bone surface around the cutting line, the “H” point of the proximal tibia, the internal and external malleolus fixators, etc.) and the correction angle (the pre-drilled holes, the wedge-shaped filling blocks, the angle-guided connecting rod, etc.) during operation, and all of them achieve good effectiveness. Conclusion Compared with conventional OWHTO, 3D printing PSCG assisted OWHTO has many obvious advantages, such as shortening the operation time, and the frequency of fluoroscopy, and being closer to the expected preoperative correction, etc. However, the effectiveness between different 3D printing PSCGs still need to be discussed in the follow-up studies.

Citation： MA Chi, PIAO Chengzhe. Application status of open-wedge high tibial osteotomy assisted by three-dimensional printing patient-specific cutting guides. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(3): 360-364. doi: 10.7507/1002-1892.202212031 Copy

1.	Song SJ, Bae DK. Computer-assisted navigation in high tibial osteotomy. Clin Orthop Surg, 2016, 8(4): 349-357.
2.	張軍, 張利勇, 宗永剛, 等. 3D打印輔助脛骨截骨治療膝內側骨關節炎現狀. 中華關節外科雜志 (電子版), 2019, 13(6): 750-754.
3.	Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am, 1979, 10(3): 585-608.
4.	Mao Y, Xiong Y, Li Q, et al. 3D-printed patient-specific instrumentation technique vs. conventional technique in medial open wedge high tibial osteotomy: A prospective comparative study. Biomed Res Int, 2020, 2020: 1923172. doi: 10.1155/2020/1923172.
5.	駱巍, 馬信龍, 黃競敏. 高位脛骨截骨術研究進展. 中國矯形外科雜志, 2018, 26(19): 1786-1789.
6.	Yang JC, Chen CF, Luo CA, et al. Clinical experience using a 3D-printed patient-specific instrument for medial opening wedge high tibial osteotomy. Biomed Res Int, 2018, 2018: 9246529. doi: 10.1155/2018/9246529.
7.	Pérez-Ma?anes R, Burró JA, Manaute JR, et al. 3D surgical printing cutting guides for open-wedge high tibial osteotomy: Do it yourself. J Knee Surg, 2016, 29(8): 690-695.
8.	Van Genechten W, Van Tilborg W, Van den Bempt M, et al. Feasibility and 3D planning of a novel patient-specific instrumentation technique in medial opening-wedge high tibial osteotomy. J Knee Surg, 2021, 34(14): 1560-1569.
9.	Chernchujit B, Tharakulphan S, Prasetia R, et al. Preoperative planning of medial opening wedge high tibial osteotomy using 3D computer-aided design weight-bearing simulated guidance: Technique and preliminary result. J Orthop Surg (Hong Kong), 2019, 27(1): 2309499019831455. doi: 10.1177/2309499019831455.
10.	Munier M, Donnez M, Ollivier M, et al. Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? Pilot study Orthop Traumatol Surg Res, 2017, 103(2): 245-250.
11.	Abdullah KA, Reed W. 3D printing in medical imaging and healthcare services. J Med Radiat Sci, 2018, 65(3): 237-239.
12.	Marro A, Bandukwala T, Mak W. Three-dimensional printing and medical imaging: A review of the methods and applications. Curr Probl Diagn Radiol, 2016, 45(1): 2-9.
13.	Han SB, Lee DH, Shetty GM, et al. A “safe zone” in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 90-95.
14.	Jörgens M, Keppler AM, Ahrens P, et al. 3D osteotomies-improved accuracy with patient-specific instruments (PSI). Eur J Trauma Emerg Surg, 2022. doi: 10.1007/s00068-022-02060-4.
15.	Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
16.	高發維, 王成功, 胡懿郃, 等. 分體式3D打印個性化導板在內側開放楔形脛骨高位截骨術中的臨床應用. 中國修復重建外科雜志, 2021, 35(9): 1119-1124.
17.	劉國彬, 劉森, 王立飛, 等. 3D打印個性化截骨輔助模塊在脛骨高位截骨術中的應用進展. 實用骨科雜志, 2022, 28(4): 328-332.
18.	Miao Z, Li S, Luo D, et al. The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study. J Orthop Surg Res, 2022, 17(1): 62. doi: 10.1186/s13018-022-02956-2.
19.	Jones GG, Jaere M, Clarke S, et al. 3D printing and high tibial osteotomy. EFORT Open Rev, 2018, 3(5): 254-259.
20.	劉國彬, 劉森, 王立飛, 等. 一種基于 “H” 點的全新3D打印個性化截骨導板輔助脛骨高位截骨術的尸體研究. 實用骨科雜志, 2021, 27(10): 941-946, 950.
21.	Liu GB, Liu S, Zhu CH, et al. A novel 3D-printed patient-specific instrument based on “H-point” for medial opening wedge high tibial osteotomy: a cadaver study. J Orthop Surg Res, 2022, 17(1): 169. doi: 10.1186/s13018-022-03057-w.
22.	王興山, 黃野, 柳劍, 等. 3D打印截骨導板輔助脛骨高位截骨術的準確性和安全性研究. 實用骨科雜志, 2021, 27(10): 865-869.
23.	柳劍, 李兵, 王興山, 等. TomoFix3D打印導板在脛骨高位截骨術中的應用方法. 實用骨科雜志, 2021, 27(10): 955-957.
24.	Jud L, Fürnstahl P, Vlachopoulos L, et al. Malpositioning of patient-specific instruments within the possible degrees of freedom in high-tibial osteotomy has no considerable influence on mechanical leg axis correction. Knee Surg Sports Traumatol Arthrosc, 2020, 28(5): 1356-1364.
25.	Ozel O, Yucel B, Mutlu S, et al. Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc, 2017, 25(1): 314-318.
26.	Jo HS, Park JS, Byun JH, et al. The effects of different hinge positions on posterior tibial slope in medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1851-1858.
27.	Victor J, Premanathan A. Virtual 3D planning and patient specific surgical guides for osteotomies around the knee: a feasibility and proof-of-concept study. Bone Joint J, 2013, 95-B(11 Suppl A): 153-158.
28.	Predescu V, Grosu AM, Gherman I, et al. Early experience using patient-specific instrumentation in opening wedge high tibial osteotomy. Int Orthop, 2021, 45(6): 1509-1515.
29.	Chaouche S, Jacquet C, Fabre-Aubrespy M, et al. Patient-specific cutting guides for open-wedge high tibial osteotomy: safety and accuracy analysis of a hundred patients continuous cohort. Int Orthop, 2019, 43(12): 2757-2765.
30.	Kim HJ, Park J, Park KH, et al. Evaluation of accuracy of a three-dimensional printed model in open-wedge high tibial osteotomy. J Knee Surg, 2019, 32(9): 841-846.
31.	趙大鵬, 宮林海, 張曉濤, 等. 3D打印截骨模具輔助下開放楔形脛骨高位截骨術治療內翻性膝骨關節炎早期療效分析. 中國現代手術學雜志, 2019, 23(5): 338-344.
32.	李小兵, 郭新軍, 馮立平, 等. 3D打印輔助高位脛骨截骨治療內側室膝骨關節炎. 中國矯形外科雜志, 2021, 29(21): 1950-1954.
33.	張利勇, 萬春飛, 張軍, 等. 3D打印個體化截骨導板輔助脛骨高位截骨術治療內翻型膝骨關節炎精準性的臨床療效. 中國臨床醫學, 2021, 28(4): 646-651.

1. Song SJ, Bae DK. Computer-assisted navigation in high tibial osteotomy. Clin Orthop Surg, 2016, 8(4): 349-357.
2. 張軍, 張利勇, 宗永剛, 等. 3D打印輔助脛骨截骨治療膝內側骨關節炎現狀. 中華關節外科雜志 (電子版), 2019, 13(6): 750-754.
3. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am, 1979, 10(3): 585-608.
4. Mao Y, Xiong Y, Li Q, et al. 3D-printed patient-specific instrumentation technique vs. conventional technique in medial open wedge high tibial osteotomy: A prospective comparative study. Biomed Res Int, 2020, 2020: 1923172. doi: 10.1155/2020/1923172.
5. 駱巍, 馬信龍, 黃競敏. 高位脛骨截骨術研究進展. 中國矯形外科雜志, 2018, 26(19): 1786-1789.
6. Yang JC, Chen CF, Luo CA, et al. Clinical experience using a 3D-printed patient-specific instrument for medial opening wedge high tibial osteotomy. Biomed Res Int, 2018, 2018: 9246529. doi: 10.1155/2018/9246529.
7. Pérez-Ma?anes R, Burró JA, Manaute JR, et al. 3D surgical printing cutting guides for open-wedge high tibial osteotomy: Do it yourself. J Knee Surg, 2016, 29(8): 690-695.
8. Van Genechten W, Van Tilborg W, Van den Bempt M, et al. Feasibility and 3D planning of a novel patient-specific instrumentation technique in medial opening-wedge high tibial osteotomy. J Knee Surg, 2021, 34(14): 1560-1569.
9. Chernchujit B, Tharakulphan S, Prasetia R, et al. Preoperative planning of medial opening wedge high tibial osteotomy using 3D computer-aided design weight-bearing simulated guidance: Technique and preliminary result. J Orthop Surg (Hong Kong), 2019, 27(1): 2309499019831455. doi: 10.1177/2309499019831455.
10. Munier M, Donnez M, Ollivier M, et al. Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? Pilot study Orthop Traumatol Surg Res, 2017, 103(2): 245-250.
11. Abdullah KA, Reed W. 3D printing in medical imaging and healthcare services. J Med Radiat Sci, 2018, 65(3): 237-239.
12. Marro A, Bandukwala T, Mak W. Three-dimensional printing and medical imaging: A review of the methods and applications. Curr Probl Diagn Radiol, 2016, 45(1): 2-9.
13. Han SB, Lee DH, Shetty GM, et al. A “safe zone” in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 90-95.
14. Jörgens M, Keppler AM, Ahrens P, et al. 3D osteotomies-improved accuracy with patient-specific instruments (PSI). Eur J Trauma Emerg Surg, 2022. doi: 10.1007/s00068-022-02060-4.
15. Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
16. 高發維, 王成功, 胡懿郃, 等. 分體式3D打印個性化導板在內側開放楔形脛骨高位截骨術中的臨床應用. 中國修復重建外科雜志, 2021, 35(9): 1119-1124.
17. 劉國彬, 劉森, 王立飛, 等. 3D打印個性化截骨輔助模塊在脛骨高位截骨術中的應用進展. 實用骨科雜志, 2022, 28(4): 328-332.
18. Miao Z, Li S, Luo D, et al. The validity and accuracy of 3D-printed patient-specific instruments for high tibial osteotomy: a cadaveric study. J Orthop Surg Res, 2022, 17(1): 62. doi: 10.1186/s13018-022-02956-2.
19. Jones GG, Jaere M, Clarke S, et al. 3D printing and high tibial osteotomy. EFORT Open Rev, 2018, 3(5): 254-259.
20. 劉國彬, 劉森, 王立飛, 等. 一種基于 “H” 點的全新3D打印個性化截骨導板輔助脛骨高位截骨術的尸體研究. 實用骨科雜志, 2021, 27(10): 941-946, 950.
21. Liu GB, Liu S, Zhu CH, et al. A novel 3D-printed patient-specific instrument based on “H-point” for medial opening wedge high tibial osteotomy: a cadaver study. J Orthop Surg Res, 2022, 17(1): 169. doi: 10.1186/s13018-022-03057-w.
22. 王興山, 黃野, 柳劍, 等. 3D打印截骨導板輔助脛骨高位截骨術的準確性和安全性研究. 實用骨科雜志, 2021, 27(10): 865-869.
23. 柳劍, 李兵, 王興山, 等. TomoFix3D打印導板在脛骨高位截骨術中的應用方法. 實用骨科雜志, 2021, 27(10): 955-957.
24. Jud L, Fürnstahl P, Vlachopoulos L, et al. Malpositioning of patient-specific instruments within the possible degrees of freedom in high-tibial osteotomy has no considerable influence on mechanical leg axis correction. Knee Surg Sports Traumatol Arthrosc, 2020, 28(5): 1356-1364.
25. Ozel O, Yucel B, Mutlu S, et al. Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc, 2017, 25(1): 314-318.
26. Jo HS, Park JS, Byun JH, et al. The effects of different hinge positions on posterior tibial slope in medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1851-1858.
27. Victor J, Premanathan A. Virtual 3D planning and patient specific surgical guides for osteotomies around the knee: a feasibility and proof-of-concept study. Bone Joint J, 2013, 95-B(11 Suppl A): 153-158.
28. Predescu V, Grosu AM, Gherman I, et al. Early experience using patient-specific instrumentation in opening wedge high tibial osteotomy. Int Orthop, 2021, 45(6): 1509-1515.
29. Chaouche S, Jacquet C, Fabre-Aubrespy M, et al. Patient-specific cutting guides for open-wedge high tibial osteotomy: safety and accuracy analysis of a hundred patients continuous cohort. Int Orthop, 2019, 43(12): 2757-2765.
30. Kim HJ, Park J, Park KH, et al. Evaluation of accuracy of a three-dimensional printed model in open-wedge high tibial osteotomy. J Knee Surg, 2019, 32(9): 841-846.
31. 趙大鵬, 宮林海, 張曉濤, 等. 3D打印截骨模具輔助下開放楔形脛骨高位截骨術治療內翻性膝骨關節炎早期療效分析. 中國現代手術學雜志, 2019, 23(5): 338-344.
32. 李小兵, 郭新軍, 馮立平, 等. 3D打印輔助高位脛骨截骨治療內側室膝骨關節炎. 中國矯形外科雜志, 2021, 29(21): 1950-1954.
33. 張利勇, 萬春飛, 張軍, 等. 3D打印個體化截骨導板輔助脛骨高位截骨術治療內翻型膝骨關節炎精準性的臨床療效. 中國臨床醫學, 2021, 28(4): 646-651.

Chinese Journal of Reparative and Reconstructive Surgery

Application status of open-wedge high tibial osteotomy assisted by three-dimensional printing patient-specific cutting guides

Abstract Full text Figures/Tables Video References Cited by

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