3D打印截骨导板辅助胫骨高位截骨术的准确性和安全性研究

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Abstract Objective To evaluate the accuracy and safety of high tibial osteotomy assisted by 3D printed guide.Methods A retrospective study was conducted on 22 patients (36 knees) who underwent medial open wedge high tibial osteotomy (OWHTO) assisted by 3D printed guide in our hospital from April 2020 to October 2020，including 11 males (16 knees) and 11 females (20 knees).The average age was (41.1±15.8)years.The differences between preoperative planned weight bearing line ratio(WBLR) and postoperative WBLR were compared，as well as the changes of posterior slope of the tibial plateau before and after operation.The operative time，frequency of intraoperative fluoroscopy，intraoperative and early postoperative complications were extracted. Results The average operation time was (40.1±12.8)min，and the frequency of fluoroscopy was (13.3±4.5).The medial proximal tibial angle (MPTA) was corrected from (83.0±1.8)° preoperatively to (90.1±2.3)° postoperatively，P＜0.001.The WBLR was adjusted from (22.6±9.7)% preoperatively to (52.9±3.8)% postoperatively，P＜0.001.There was no significant difference between the postoperative MPTA and the targeted MPTA value (90.4±2.2)° (P＝0.159).The postoperative WBLR (52.9±3.8)% was significantly different from the preoperative target WBLR (54.4±3.3)% (P＝0.005)，and the difference was (1.5±3.1)%.The posterior tibial slope(PTS) was (10.4±3.5)° preoperatively and (10.2±3.3)° postoperatively (P＝0.077).There were 2 cases of lateral hinge fracture in this group，including 1 case of Takeuchi type I fracture and 1 case of Takeuchi type Ⅲ fracture.The fracture healed well eventually，with no displacement or loss of correction.Conclusion OWHTO assisted by 3D printed guide can achieve precise correction of the WBL，while maintaining the slope of the tibial plateau，good accuracy and safety can be obtained.

Key words： 3D printing guide tibia osteotomy

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