改良 3D打印个体化导向器辅助全膝关节置换术的假体型号与术前规划一致性分析

Objective To explore the prediction accuracy of prosthesis size of the modified 3D printed patient-specific instrumentation (PSI) -assisted total knee arthroplasty (TKA) by comparing the difference between intraoperative prosthesis size and preoperative planned prosthesis size. Methods We optimized and improved the workflow, design scheme, shape of guide, operation technology and verification method of the traditional PSI-assisted TKA. A total of 126 patients (137 knees) who received 3D printed PSI-assisted TKA based on preoperative CT images in our center were recruited in this study. The differences between the actual prosthesis size and the preoperative planned size were compared and analyzed. Results All patients completed the surgery successfully, and no serious complications occurred. For the femoral side, the difference between the actual used size and the doctor's planned size was observed in 7 cases, and the difference between the actual used size and the engineer's planned size was in 25 cases (P<0. 01), and the engineer's planned size adjusted by doctors was 19 cases (P<0. 01). For the tibial side, the actual used size and the doctor's planned size was 39 cases, the difference between the actual used size and the engineer's planned size was 44 cases, and the engineer's planned size adjusted by doctors was 5 cases. Conclusion The planned prosthesis size in Our modified 3D printed PSI-assisted TKA is consistent with the intraoperative prosthesis size, and the plan will be more consistent after adjustment by the doctors.