Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee Arthroplasty
Objective Total knee arthroplasty (TKA) is one of the most universal and effective means for treating terminal stage osteoarthritis (OA) of knee. Accurate intramedullary guide of femur is the basis for the distal femoral cuts. Determining the surgical transepicondylar axis (sTEA) is the key to recon...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-04-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.12619 |
| _version_ | 1811224980338245632 |
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| author | Mao‐lin Sun Ying Zhang Yang Peng De‐jie Fu Hua‐quan Fan Rui He |
| author_facet | Mao‐lin Sun Ying Zhang Yang Peng De‐jie Fu Hua‐quan Fan Rui He |
| author_sort | Mao‐lin Sun |
| collection | DOAJ |
| description | Objective Total knee arthroplasty (TKA) is one of the most universal and effective means for treating terminal stage osteoarthritis (OA) of knee. Accurate intramedullary guide of femur is the basis for the distal femoral cuts. Determining the surgical transepicondylar axis (sTEA) is the key to reconstruction of the femoral rotational alignment, because the correct rotational alignment can place the femoral component in the right position, balance the flexion gap so that the inner and outer tension is equal, get stability during the flexion process of the knee, and enhance the quality of life of patients. With the development of three‐dimensional printing (3DP) technology in the medical domain, the application of patient‐specific instrumentation (PSI) in arthroplasty has become more common. The aim of this study was to evaluate the accuracy of a novel 3D‐printed patient‐specific intramedullary guide to control femoral component rotation in TKA. Methods Eighty patients (65 females and 15 males) with knee OA were included in this prospective randomized study. The patients were divided into two groups by random number table method, 40 in each group. TKA assisted by PSI (PSI group) and conventional TKA (conventional group) was performed respectively. Clinical outcomes [operation time, postoperative drainage volume, duration of drainage, Hospital for Special Surgery knee score (HSS), American Knee Society knee score (AKS)] and radiological outcomes [hip‐knee‐ankle angle (HKA), posterior condylar angle (PCA), patella transverse axis‐femoral transepicondylar axis angle (PFA), depth of intramedullary guide] were compared between and within the two groups. Results PSI group had less postoperative drainage volume but longer operation time than the conventional group (P < 0.05). The AKS and HSS scores after surgery were improved compared with those before surgery in each group (P < 0.05). However, there was no significant difference in the duration of drainage and range of motion (ROM) after surgery between the two groups. For the radiological results, the HKA and PFA were improved after surgery in both groups (P < 0.05).The postoperative PFA and PCA of the PSI group were closer to 0°, which was better than that of the conventional group (P < 0.05). The depth of intramedullary guide in the PSI group was less than the conventional group (P < 0.05). But there was no significant difference in HKA before and after surgery between the two groups as well as the preoperative PFA. Conclusion The short‐term clinical efficacy of TKA assisted by PSI was similar to the conventional TKA. Although TKA assisted by PSI spent more time during operation, it could assist in intramedullary guide and align femoral rotation more accurately. |
| first_indexed | 2024-04-12T08:58:00Z |
| format | Article |
| id | doaj.art-2e360300264d4455a60a9b5736f8c54d |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-12T08:58:00Z |
| publishDate | 2020-04-01 |
| publisher | Wiley |
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| series | Orthopaedic Surgery |
| spelling | doaj.art-2e360300264d4455a60a9b5736f8c54d2022-12-22T03:39:19ZengWileyOrthopaedic Surgery1757-78531757-78612020-04-0112242944110.1111/os.12619Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee ArthroplastyMao‐lin Sun0Ying Zhang1Yang Peng2De‐jie Fu3Hua‐quan Fan4Rui He5Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University) Chongqing ChinaCenter for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University) Chongqing ChinaCenter for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University) Chongqing ChinaCenter for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University) Chongqing ChinaCenter for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University) Chongqing ChinaCenter for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University) Chongqing ChinaObjective Total knee arthroplasty (TKA) is one of the most universal and effective means for treating terminal stage osteoarthritis (OA) of knee. Accurate intramedullary guide of femur is the basis for the distal femoral cuts. Determining the surgical transepicondylar axis (sTEA) is the key to reconstruction of the femoral rotational alignment, because the correct rotational alignment can place the femoral component in the right position, balance the flexion gap so that the inner and outer tension is equal, get stability during the flexion process of the knee, and enhance the quality of life of patients. With the development of three‐dimensional printing (3DP) technology in the medical domain, the application of patient‐specific instrumentation (PSI) in arthroplasty has become more common. The aim of this study was to evaluate the accuracy of a novel 3D‐printed patient‐specific intramedullary guide to control femoral component rotation in TKA. Methods Eighty patients (65 females and 15 males) with knee OA were included in this prospective randomized study. The patients were divided into two groups by random number table method, 40 in each group. TKA assisted by PSI (PSI group) and conventional TKA (conventional group) was performed respectively. Clinical outcomes [operation time, postoperative drainage volume, duration of drainage, Hospital for Special Surgery knee score (HSS), American Knee Society knee score (AKS)] and radiological outcomes [hip‐knee‐ankle angle (HKA), posterior condylar angle (PCA), patella transverse axis‐femoral transepicondylar axis angle (PFA), depth of intramedullary guide] were compared between and within the two groups. Results PSI group had less postoperative drainage volume but longer operation time than the conventional group (P < 0.05). The AKS and HSS scores after surgery were improved compared with those before surgery in each group (P < 0.05). However, there was no significant difference in the duration of drainage and range of motion (ROM) after surgery between the two groups. For the radiological results, the HKA and PFA were improved after surgery in both groups (P < 0.05).The postoperative PFA and PCA of the PSI group were closer to 0°, which was better than that of the conventional group (P < 0.05). The depth of intramedullary guide in the PSI group was less than the conventional group (P < 0.05). But there was no significant difference in HKA before and after surgery between the two groups as well as the preoperative PFA. Conclusion The short‐term clinical efficacy of TKA assisted by PSI was similar to the conventional TKA. Although TKA assisted by PSI spent more time during operation, it could assist in intramedullary guide and align femoral rotation more accurately.https://doi.org/10.1111/os.126193D PrintingIntramedullary guidePatient‐specific instrumentationRotational alignmentSurgical transepicondylar axisTotal knee arthroplasty |
| spellingShingle | Mao‐lin Sun Ying Zhang Yang Peng De‐jie Fu Hua‐quan Fan Rui He Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee Arthroplasty Orthopaedic Surgery 3D Printing Intramedullary guide Patient‐specific instrumentation Rotational alignment Surgical transepicondylar axis Total knee arthroplasty |
| title | Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee Arthroplasty |
| title_full | Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee Arthroplasty |
| title_fullStr | Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee Arthroplasty |
| title_full_unstemmed | Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee Arthroplasty |
| title_short | Accuracy of a Novel 3D‐Printed Patient‐Specific Intramedullary Guide to Control Femoral Component Rotation in Total Knee Arthroplasty |
| title_sort | accuracy of a novel 3d printed patient specific intramedullary guide to control femoral component rotation in total knee arthroplasty |
| topic | 3D Printing Intramedullary guide Patient‐specific instrumentation Rotational alignment Surgical transepicondylar axis Total knee arthroplasty |
| url | https://doi.org/10.1111/os.12619 |
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