Objective To investigate the accuracy and safety of simulated surgery combined with 3D printing patient-specific instrumentation (PSI) assisted medial open wedge high tibial osteotomy (HTO) in knee osteoarthritis. Methods The clinical data of 23 patients with knee osteoarthritis who were treated with simulated surgery combined with 3D printing PSI assisted medial open-wedge HTO between May 2019 and May 2021 were retrospectively analyzed. There were 2 males and 21 females, with an average age of 58.9 years (ranged 49-83 years). The disease duration ranged from 1 to 30 years, with an average of 6.3 years. Postoperatively, the weight bearing lineratio(WBL), medial proximal tibial angle (MPTA), hip-knee-ankle angle (PTSA), knee-ankle angle (HKA) and joint line convergence angle (JLCA) were measured and compared with the preoperative values, and the postoperative WBL, HKA, MPTA and actual correction angle of the lower limbs were compared with the preoperative design target values. At the final follow-up, the knee pain and function were assessed by VAS and AKS. Results All the patients were followed up for 7-19 months, with an average of 11.8 months. The postoperative WBL (57.52±3.99) %, MPTA (90.77±0.68)°, HKA (182.84±1.58)°, and JCLA (0.17±0.36)°were significantly improved compared with the preoperative values (P<0.05). There was no significant difference between preoperative and postoperative PTSA (P>0.05). The postoperative WBL, MPTA, HKA and actual correction angle of the lower limbs were slightly lower than the preoperative design target values, but the differences were not significant(P>0.05). At the final follow-up, the VAS scores were (0.78±0.52), which were significantly lower than the preoperative VAS scores (P<0.05). The AKS scores were (88.52±2.98), which were significantly higher than the preoperative AKS scores (P<0.05). Conclusions Simulated surgery combined with 3D printing PSI surgery assisted HTO is an effective method in knee osteoarthritis, which can achieve satisfactory clinical effects.
Key words
Knee osteoarthritis; /
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3D printing; /
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High tibial osteotomy; /
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Simulated surgery; /
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Patient-specific instrumentation
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