ABSTRACT
OBJECTIVE: To compare the clinical efficacy between personalised 3-dimensional (3D) printed osteotomy and traditional osteotomy in periacetabular osteotomy (PAO). METHODS: Twenty-two patients with acetabular dysplasia were randomly divided into a personalised 3D-printed osteotomy group and a traditional osteotomy group without 3D printing assistance. The operation time, intraoperative blood loss, X-ray frequency, quantity of postoperative drainage, postoperative transfusion rate, hip angle and Harris hip score of 6 months postoperative were studied and compared to evaluate the surgical efficacy between personalised 3D-printed osteotomy and traditional osteotomy in periacetabular osteotomy. RESULTS: The operation time, intraoperative blood loss, X-ray frequency, postoperative 24 h drainage volume in the personalised 3D-printed osteotomy group (114.70 ± 2.21 min, 639.70 ± 5.00 mL, 11.82 ± 0.42 times, 231.20 ± 3.86 mL) was superior to the traditional group (150.40 ± 2.45 min, 850.50 ± 5.34 mL, 17.09 ± 0.39 times, 324.30 ± 4.06 mL). There was a statistically significant difference between the 3D-printed osteotomy group and the traditional osteotomy group in terms of the operation time, intraoperative blood loss, X-ray frequency and postoperative 24 h drainage volume (p < 0.05). And there were no substantial differences in the hip angle and the 6-month postoperative Harris hip score between the two groups (p > 0.05). CONCLUSION: The 3D-printed osteotomy template for PAO is a valid method and its short-term clinical effect is superior to that of traditional osteotomy.
Subject(s)
Acetabulum , Hip Dislocation, Congenital , Acetabulum/diagnostic imaging , Acetabulum/surgery , Blood Loss, Surgical , Hip Dislocation, Congenital/surgery , Humans , Osteotomy/methods , Printing, Three-Dimensional , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: To explore the application value of self-made tibial mechanical axis locator in tibial extra-articular deformity in total knee arthroplasty (TKA) for improving the lower extremity force line. METHODS: Between January and August 2012, 13 cases (21 knees) of osteoarthritis with tibial extra-articular deformity were treated, including 5 males (8 knees) and 8 females (13 knees) with an average age of 66.5 years (range, 58-78 years). The disease duration was 2-5 years (mean, 3.5 years). The knee society score (KSS) was 45.5 +/- 15.5. Extra-articular deformities included 1 case of knee valgus (2 knees) and 12 cases of knee varus (19 knees). Preoperative full-length X-ray films of lower extremities showed 10-21 degrees valgus or varus deformity of tibial extra joint. Self-made tibial mechanical axis locator was used to determine and mark coronal tibial mechanical axis under X-ray before TKA, and then osteotomy was performed with extramedullary positioning device according to the mechanical axis marker.' RESULTS: All incisions healed by first intention, without related complications of infection and joint instability. All patients were followed up 5-12 months (mean, 8.3 months). The X-ray examination showed < 2 degrees knee deviation angle in the others except 1 case of 2.9 degrees knee deviation angle at 3 days after operation, and the accurate rate was 95.2%. No loosening or instability of prosthesis occurred during follow-up. KSS score was 85.5 +/- 15.0 at last follow-up, showing significant difference when compared with preoperative score (t=12.82, P=0.00). CONCLUSION: The seft-made tibial mechanical axis locator can improve the accurate rate of the lower extremity force line in TKA for tibia extra-articular deformity.
