生物骨科材料与临床研究2026，Vol.23Issue(4)：46-51,6.DOI:10.3969/j.issn.1672-5972.2026.04.009
3D打印个性化截骨导板在膝关节置换术中精准重建下肢力线的临床疗效
Clinical efficacy of 3D-printed personalized osteotomy guides in accurate reconstruction of lower limb mechanical alignment during total knee arthroplasty
摘要
Abstract
Objective To investigate the effectiveness of using 3D-printed personalized guides in total knee arthroplasty(TKA)for achieving precise positioning of femoral rotational alignment,optimizing patellar tracking,and reconstructing postoperative lower limb mechanical alignment.Methods A retrospective study was conducted on 60 knee osteoarthritis patients who underwent TKA at department of joint surgery and orthopedic center,People's Hospital of Xinjiang Uygur Autonomous Region between January 2023 and March 2024,meeting inclusion criteria.The cohort comprised two groups:30 patients receiving 3D-printed personalized osteotomy guide-assisted TKA(3D guide group)and 30 patients undergoing conventional TKA(conventional group).Comparative analyses were performed on baseline characteristics(age,gender,surgical side)and perioperative indicators(operative time,intraoperative blood loss).Systematic evaluations included radiographic parameter changes,such as posterior condylar angle(PCA),patellar transverse axis-femoral transepicondylar line angle(PFA),hip-knee-ankle angle(HKA),and functional score improvements,such as American Knee Society Score(AKS),Hospital for Special Surgery Score(HSS)pre-and postoperatively.Postoperative adverse events were documented.Results All procedures were successfully completed.The mean follow-up was(6.41±0.82)months(range:5-7 months),with no major perioperative complications.Statistical analysis revealed that the postoperative HKA angle in the 3D-PSI group(179.43°±0.27°)was significantly closer to the neutral mechanical axis compared to the conventional group(178.49°±0.50°)(P<0.05).Furthermore,the 3D-PSI group exhibited significantly lower postoperative PCA(0.45°±0.58°)and PFA angles(0.46°±0.55°)than the conventional group(0.97°±0.24° and 1.00°±0.27°,respectively)(P<0.05).Additionally,at the 6-month follow-up,the 3D-PSI group demonstrated superior HSS(92.43±2.53)and AKS scores(91.57±2.66)compared to the conventional group(87.93±2.06 and 89.73±2.00)(P<0.001).Conclusion Compared to conventional TKA,TKA assisted by 3D-printed patient-specific guides provides more accurate reconstruction of lower limb mechanical alignment and leads to better early functional recovery,demonstrating significant clinical application value.关键词
3D打印/截骨导板/膝关节骨关节炎/人工全膝关节置换术/髌骨轨迹/下肢力线/股骨旋转对线Key words
3D printing/Osteotomy guide plate/Knee osteoarthritis/Total knee arthroplasty/Patellar tracking/Lower limb alignment/Femoral rotational alignment分类
医药卫生引用本文复制引用
韩衍龙,米安民,叶子昂,赵巍,哈巴西·卡肯,王利..3D打印个性化截骨导板在膝关节置换术中精准重建下肢力线的临床疗效[J].生物骨科材料与临床研究,2026,23(4):46-51,6.基金项目
新疆维吾尔自治区人民医院精准医学项目(20220305) （20220305）
