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Objective: To investigate the effect of three-dimensional (3D) printing guide plate on improving femoral rotational alignment and patellar tracking in total knee arthroplasty (TKA). Methods: Between January 2018 and October 2018, 60 patients (60 knees) with advanced knee osteoarthritis who received TKA and met the selection criteria were selected as the study subjects. Patients were randomly divided into two groups according to the random number table method, with 30 patients in each group. The TKA was done with the help of 3D printing guide plate in the guide group and following traditional procedure in the control group. There was no significant difference in gender, age, disease duration, side, and preoperative hip-knee-ankle angle (HKA), posterior condylar angle (PCA), patella transverse axis-femoral transepicondylar axis angle (PFA), Hospital for Special Surgery (HSS) score, and American Knee Society (AKS) score ( P>0.05). Results: All incisions healed by first intention and no complications related to the operation occurred. All patients were followed up 10-12 months, with an average of 11 months. HSS score and AKS score of the two groups at 6 months after operation were significantly higher than those before operation ( P0.05). Postoperative X-ray films showed that the prosthesis was in good position, and no prosthesis loosening or sinking occurred during follow-up. HKA, PCA, and PFA significantly improved in the two groups at 10 months after operation compared with those before operation ( P<0.05). There was no significant difference in HKA at 10 months between the two groups ( t=1.031, P=0.307). PCA and PFA in the guide group were smaller than those in the control group ( P<0.05). Conclusion: Application of 3D printing guide plate in TKA can not only correct the deformity of the knee joint and alleviate the pain symptoms, but also achieve the goal of the accurate femoral rotation alignment and good patellar tracking.
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Objective: To investigate the short-term effectiveness of three-dimensional (3D) printing personalized prosthesis in the treatment of giant cell tumor of bone around knee joint. Methods: A clinical data of 9 patients with giant cell tumor of bone around knee joints and met the inclusive criteria between May 2014 and August 2017 was retrospectively analysed. There were 4 males and 5 females, with an average age of 35.8 years (range, 24-50 years). The lesion located at the distal femur in 4 cases and at the proximal tibia in 5 cases. The disease duration was 5-25 months (mean, 12.9 months). According to Campanacci grading, there were 2 patients of grade Ⅰ and 7 of grade Ⅱ. The 3D printing personalized prosthesis was designed based on the CT scanning and 3D reconstruction prepared before operation. All patients were treated with the tumor resection and 3D printing personalized prosthesis reconstruction. The radiological examination was taken to observe the tumor recurrence and the Musculoskeletal Tumor Society 1993 (MSTS93) score was used to evaluate the knee function. Results: All operations were successful and all incisions healed by first intention without early complications. All patients were followed up 24-40 months (mean, 31.2 months). At last follow-up, no complication such as pain, pathological fracture, prosthesis loosening, or tumor recurrence occurred. The MSTS93 score was 20-29 (mean, 24.7). The knee function was rated as excellent in 6 cases and good in 3 cases, with the excellent and good rate of 100%. Conclusion: For giant cell tumor of bone around knee joint, 3D printing personalized prosthesis has the advantages of bio-fusion with host bone, mechanical stability, good joint function, and ideal short-term effectiveness. But the middle- and long-term effectiveness still need to be further observed.
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OBJECTIVE@#This study aimed to investigate the application of an osteotomy template and a repositioning template manufactured by three-dimensional (3D) printing technique in maxillary LeFortⅠosteotomy.@*METHODS@#The patient group consisted of eight patients with maxillary hypoplasia who underwent LeFortⅠosteotomy. The mean age at the time of surgery was 25.6 years old. All patients were scanned using cone beam computed tomography (CBCT) to create a 3D model of the maxillary. The osteotomy and repositioning templates of the LeFortⅠosteotomy were manufactured by 3D printing technique. All bones were cut by the same doctor with extensive orthognathic surgery experience. One part of the template guided the osteotomy, and the other repositioned the maxilla during operation. Postoperative CBCT scan was performed, and the virtual plan was compared with the postoperative surgical result using an image fusion of the CBCT dataset by analyzing measurements between six landmarks relative to three reference planes. Statistical analysis was performed, and accuracy was reported using SPSS 16.0 software package.@*RESULTS@#Primary healing of incisions was observed in all patients, and no serious complications were observed. The maximum mean values were 1.35 mm, and the displacement error was UL6 to the coronal plane. The maximum standard deviation was 0.85, and the maximum standard error was 0.30, which was acceptable by clinical standards.@*CONCLUSIONS@#The application of osteotomy and repositioning templates manufactured by 3D printing technique in maxillary LeFortⅠosteotomy was safe and can enable doctors to complete a surgery accurately.
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Adult , Humans , Cone-Beam Computed Tomography , Imaging, Three-Dimensional , Maxilla , Orthognathic Surgical Procedures , Printing, Three-DimensionalABSTRACT
OBJECTIVE: To summarize the current research progress of three-dimensional (3D) printing technique for spinal implants manufacture. METHODS: The recent original literature concerning technology, materials, process, clinical applications, and development direction of 3D printing technique in spinal implants was reviewed and analyzed. RESULTS: At present, 3D printing technologies used to manufacture spinal implants include selective laser sintering, selective laser melting, and electron beam melting. Titanium and its alloys are mainly used. 3D printing spinal implants manufactured by the above materials and technology have been successfully used in clinical. But the problems regarding safety, related complications, cost-benefit analysis, efficacy compared with traditional spinal implants, and the lack of relevant policies and regulations remain to be solved. CONCLUSIONS: 3D printing technique is able to provide individual and customized spinal implants for patients, which is helpful for the clinicians to perform operations much more accurately and safely. With the rapid development of 3D printing technology and new materials, more and more 3D printing spinal implants will be developed and used clinically.