Effectiveness of digital three-dimensional printing osteotomy guide plate assisted total knee arthroplasty in treatment of knee osteoarthritis patients with femoral internal implant_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Chao ^1,2 ,  ZHANG Binbin ¹ , LIU Xiangping ¹ , LI Haiya ¹ , ZHANG Jingtang ¹ , WU Min ²

1. Department of Orthopedics, Taihe County People’s Hospital, Fuyang Anhui, 236600, P. R. China;
2. Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P. R. China;

Corresponding?author：

ZHANG Binbin, Email: 2005-zyb@163.com

Keywords：

Three-dimensional printing osteotomy guide plate; total knee arthroplasty; femoral implants; knee osteoarthritis

DOI：

10.7507/1002-1892.202411104

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Objective To investigate the effectiveness of digital three-dimensional (3D) printing osteotomy guide plate assisted total knee arthroplasty (TKA) in treatment of knee osteoarthritis (KOA) patients with femoral internal implants. Methods The clinical data of 55 KOA patients who met the selection criteria between July 2021 and October 2023 were retrospectively analyzed. Among them, 26 cases combined with femoral implants were treated with digital 3D printing osteotomy guide plate assisted TKA (guide plate group), and 29 cases were treated with conventional TKA (control group). There was no significant difference in gender, age, body mass index, side, Kellgren-Lawrence classification, preoperative visual analogue scale (VAS) score, Hospital for Special Surgery (HSS) knee score, knee range of motion, and other baseline data between the two groups (P>0.05). The operation time, intraoperative blood loss, incision length, postoperative first ambulation time, surgical complications; VAS score, knee HSS score, knee range of motion before operation, at 1 week and 3 months after operation, and at last follow-up; distal femoral lateral angle, proximal tibial medial angle, hip-knee-ankle angle and other imaging indicators at last follow-up were recorded and compared between the two groups. Results The operation time, incision length, intraoperative blood loss, and postoperative first ambulation time in the guide plate group were significantly lower than those in the control group (P<0.05). In the control group, there were 1 case of incision rupture and bleeding and 1 case of lower limb intermuscular venous thrombosis, which was cured after symptomatic treatment. There was no complication such as neurovascular injury, incision infection, or knee prosthesis loosening in both groups. Patients in both groups were followed up 12-26 months, with an average of 16.25 months. The VAS score, HSS score, and knee range of motion improved at each time point after operation in both groups, and further improved with time after operation, the differences were significant (P<0.05). The above indicators in the guide plate group were significantly better than those in the control group at 1 week and 3 months after operation (P<0.05), and there was no significant difference between the two groups at last follow-up (P>0.05). At last follow-up, the distal femoral lateral angle, the proximal tibial medial angle, and the hip-knee-ankle angle in the guide plate group were significantly better than those in the control group (P<0.05). Conclusion The application of digital 3D printing osteotomy guide plate assisted TKA in the treatment of KOA patients with femoral implants can simplify the surgical procedures, overcome limitations of conventional osteotomy guides, reduce surgical trauma, achieve individualized and precise osteotomy, and effectively restore lower limb alignment and knee joint function.

Citation： LI Chao, ZHANG Binbin, LIU Xiangping, LI Haiya, ZHANG Jingtang, WU Min. Effectiveness of digital three-dimensional printing osteotomy guide plate assisted total knee arthroplasty in treatment of knee osteoarthritis patients with femoral internal implant. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(2): 151-157. doi: 10.7507/1002-1892.202411104 Copy

1.	車向東, 張戰峰, 李茂山, 等. 3D打印輔助脛骨高位截骨治療內翻型膝骨關節炎. 中國矯形外科雜志, 2023, 31(24): 2215-2220.
2.	Loures FB, Correia W, Reis JH, et al. Outcomes after knee arthroplasty in extra-articular deformity. Int Orthop, 2019, 43(9): 2065-2070.
3.	張斌斌, 吳泳銳, 李超, 等. 基于3D打印個性化截骨導板在內翻膝患者膝關節雙間室置換術中的應用. 實用醫學雜志, 2024, 40(17): 2448-2453.
4.	王宇寧, 朱浩天, 劉康, 等. 數字化精準全膝關節置換與傳統置換方法的短期效果對比. 中國組織工程研究, 2025, 29(21): 4521-4528.
5.	趙資堅, 張榮臻, 蔡史健, 等. 3D打印截骨導板輔助全膝關節置換術治療膝關節外骨折后遺膝關節骨性關節炎. 中國骨與關節損傷雜志, 2022, 37(6): 580-584.
6.	吳迪, 司麗娜, 武麗珠, 等. 3D打印截骨導板在重度膝骨性關節炎患者多半徑假體全膝關節置換術中的應用效果. 實用醫學雜志, 2022, 38(2): 190-195.
7.	Amano T, Tanaka S, Ito H. Identifying activity limitation and decline in quality of life in patients with knee osteoarthritis who are scheduled to undergo total knee arthroplasty. J UOEH, 2021, 43(1): 33-39.
8.	樊宗慶, 姚云峰, 儲成頂, 等. 復雜下肢畸形3D打印輔助一期截骨全膝置換術. 中國矯形外科雜志, 2022, 30(15): 1406-1409.
9.	Zheng K, Sun H, Zhang W, et al. Mid-term outcomes of navigation-assisted primary total knee arthroplasty using adjusted mechanical alignment. Orthop Surg, 2023, 15(1): 230-238.
10.	Seil R, Pape D. Causes of failure and etiology of painful primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2011, 19(9): 1418-1432.
11.	Ritter MA, Davis KE, Meding JB, et al. The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg (Am), 2011, 93(17): 1588-1596.
12.	李鋒偵, 鄒士平, 司文騰, 等. 個性化3D打印導航模板在膝關節創傷性關節炎全膝關節置換術中的應用效果觀察. 中國骨與關節損傷雜志, 2022, 37(2): 130-133.
13.	陳龍飛, 宋岳, 谷旺, 等. Naton機器人輔助膝關節內側單髁置換術假體型號選擇的準確性研究. 中國修復重建外科雜志, 2024, 38(11): 1312-1316.
14.	Tian R, Duan X, Kong N, et al. Robotic-assisted total knee arthroplasty is more advantageous for knees with severe deformity: a randomized controlled trial study design. Int J Surg, 2023, 109(3): 287-296.
15.	李亦丞, 張曉崗, 曹力, 等. 國產機器人輔助與傳統人工全膝關節置換術療效比較: 一項多中心隨機對照研究. 中國修復重建外科雜志, 2023, 37(11): 1326-1334.
16.	李祎, 李奎蒙, 王彥琴, 等. 3D打印截骨導板在膝骨關節炎患者全膝關節置換術中的應用. 中華骨與關節外科雜志, 2024, 17(8): 707-713.
17.	Dion C, Yamomo G, Howard J, et al. Revision total knee arthroplasty using a novel 3D printed titanium augment: A biomechanical cadaveric study. J Mech Behav Biomed Mater, 2020, 110: 103944. doi: 10.1016/j.jmbbm.2020.103944.

1. 車向東, 張戰峰, 李茂山, 等. 3D打印輔助脛骨高位截骨治療內翻型膝骨關節炎. 中國矯形外科雜志, 2023, 31(24): 2215-2220.
2. Loures FB, Correia W, Reis JH, et al. Outcomes after knee arthroplasty in extra-articular deformity. Int Orthop, 2019, 43(9): 2065-2070.
3. 張斌斌, 吳泳銳, 李超, 等. 基于3D打印個性化截骨導板在內翻膝患者膝關節雙間室置換術中的應用. 實用醫學雜志, 2024, 40(17): 2448-2453.
4. 王宇寧, 朱浩天, 劉康, 等. 數字化精準全膝關節置換與傳統置換方法的短期效果對比. 中國組織工程研究, 2025, 29(21): 4521-4528.
5. 趙資堅, 張榮臻, 蔡史健, 等. 3D打印截骨導板輔助全膝關節置換術治療膝關節外骨折后遺膝關節骨性關節炎. 中國骨與關節損傷雜志, 2022, 37(6): 580-584.
6. 吳迪, 司麗娜, 武麗珠, 等. 3D打印截骨導板在重度膝骨性關節炎患者多半徑假體全膝關節置換術中的應用效果. 實用醫學雜志, 2022, 38(2): 190-195.
7. Amano T, Tanaka S, Ito H. Identifying activity limitation and decline in quality of life in patients with knee osteoarthritis who are scheduled to undergo total knee arthroplasty. J UOEH, 2021, 43(1): 33-39.
8. 樊宗慶, 姚云峰, 儲成頂, 等. 復雜下肢畸形3D打印輔助一期截骨全膝置換術. 中國矯形外科雜志, 2022, 30(15): 1406-1409.
9. Zheng K, Sun H, Zhang W, et al. Mid-term outcomes of navigation-assisted primary total knee arthroplasty using adjusted mechanical alignment. Orthop Surg, 2023, 15(1): 230-238.
10. Seil R, Pape D. Causes of failure and etiology of painful primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2011, 19(9): 1418-1432.
11. Ritter MA, Davis KE, Meding JB, et al. The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg (Am), 2011, 93(17): 1588-1596.
12. 李鋒偵, 鄒士平, 司文騰, 等. 個性化3D打印導航模板在膝關節創傷性關節炎全膝關節置換術中的應用效果觀察. 中國骨與關節損傷雜志, 2022, 37(2): 130-133.
13. 陳龍飛, 宋岳, 谷旺, 等. Naton機器人輔助膝關節內側單髁置換術假體型號選擇的準確性研究. 中國修復重建外科雜志, 2024, 38(11): 1312-1316.
14. Tian R, Duan X, Kong N, et al. Robotic-assisted total knee arthroplasty is more advantageous for knees with severe deformity: a randomized controlled trial study design. Int J Surg, 2023, 109(3): 287-296.
15. 李亦丞, 張曉崗, 曹力, 等. 國產機器人輔助與傳統人工全膝關節置換術療效比較: 一項多中心隨機對照研究. 中國修復重建外科雜志, 2023, 37(11): 1326-1334.
16. 李祎, 李奎蒙, 王彥琴, 等. 3D打印截骨導板在膝骨關節炎患者全膝關節置換術中的應用. 中華骨與關節外科雜志, 2024, 17(8): 707-713.
17. Dion C, Yamomo G, Howard J, et al. Revision total knee arthroplasty using a novel 3D printed titanium augment: A biomechanical cadaveric study. J Mech Behav Biomed Mater, 2020, 110: 103944. doi: 10.1016/j.jmbbm.2020.103944.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of digital three-dimensional printing osteotomy guide plate assisted total knee arthroplasty in treatment of knee osteoarthritis patients with femoral internal implant

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