Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysis
Abstract Purpose To evaluate the operation and early clinical effect in primary total knee arthroplasty (TKA) about the novel combination of CT-based patient-specific three-dimensional (3D) preoperative design and conventional osteotomy instruments, compared with the conventional method. Methods Aft...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-12-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-020-02123-5 |
| _version_ | 1811186114236514304 |
|---|---|
| author | Kai Lei Li Ming Liu Yi Xiang Xin Chen Hua Quan Fan Yang Peng Jiang Ming Luo Lin Guo |
| author_facet | Kai Lei Li Ming Liu Yi Xiang Xin Chen Hua Quan Fan Yang Peng Jiang Ming Luo Lin Guo |
| author_sort | Kai Lei |
| collection | DOAJ |
| description | Abstract Purpose To evaluate the operation and early clinical effect in primary total knee arthroplasty (TKA) about the novel combination of CT-based patient-specific three-dimensional (3D) preoperative design and conventional osteotomy instruments, compared with the conventional method. Methods After a 1:1 propensity score-matching (PSM), patients were matched to the novel technique group and the conventional group, 109 cases in each group. The conventional group adopted a preoperative design based on a full-length radiograph (FLX) and received TKA with conventional osteotomy instruments. The novel technique group used a CT-based patient-specific 3D preoperative design combined with conventional osteotomy instruments; during the surgery, the femoral entry point, femoral valgus osteotomy angle, the fix point of tibial plateau extramedullary guide pin, and the position of tibial extramedullary positioning rod were accurately selected according to the preoperative 3D design to ensure accurate intraoperative implementation. The lower limb alignment, component position, operation time, tourniquet time, hospital stay, blood loss volume, incidence of postoperative complications, visual analog scale (Vas) score, and New Knee Society Score System (NEW-KSS) at 1 day before operation and 1, 6, and 12 months after operation were recorded and compared. Results The novel technique group was significantly better than the conventional group in controlling lateral tibial component angle (LTC) (P < 0.001), and the novel technique group had lower percentages of hip-knee-ankle angle (HKA) outliers (P < 0.001) and overcorrection (P = 0.003). The operation time, tourniquet time, and hospital stay of the novel technique group was shorter (P < 0.05). In 1 month after the operation, the novel technique group achieved a significantly better VAS score (P < 0.05), but a similar NEW-KSS score (P > 0.05) when compared with the conventional group. But in 6 and 12 months after surgery, no statistical differences were seen in the above two scores (P > 0.05). Conclusion The novel technique of CT-based patient-specific 3D preoperative design combined with conventional instruments can improve the accuracy of osteotomy in primary total knee arthroplasty, with benefits of significantly reducing pain and rapid recovery during the early postoperative period, but having no obvious effect on outcome after a 1-year follow-up. |
| first_indexed | 2024-04-11T13:40:14Z |
| format | Article |
| id | doaj.art-e152abb5f4e540388e613149a45ab131 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:40:14Z |
| publishDate | 2020-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-e152abb5f4e540388e613149a45ab1312022-12-22T04:21:17ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-12-0115111210.1186/s13018-020-02123-5Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysisKai Lei0Li Ming Liu1Yi Xiang2Xin Chen3Hua Quan Fan4Yang Peng5Jiang Ming Luo6Lin Guo7Center for Joint Surgery, Southwest Hospital, Third Military Medical UniversityCenter for Joint Surgery, Southwest Hospital, Third Military Medical UniversityDepartment of Orthopaedics, Logistic Support Forces of the Chinese PLA 985 HospitalCenter for Joint Surgery, Southwest Hospital, Third Military Medical UniversityCenter for Joint Surgery, Southwest Hospital, Third Military Medical UniversityCenter for Joint Surgery, Southwest Hospital, Third Military Medical UniversityCenter for Joint Surgery, Southwest Hospital, Third Military Medical UniversityCenter for Joint Surgery, Southwest Hospital, Third Military Medical UniversityAbstract Purpose To evaluate the operation and early clinical effect in primary total knee arthroplasty (TKA) about the novel combination of CT-based patient-specific three-dimensional (3D) preoperative design and conventional osteotomy instruments, compared with the conventional method. Methods After a 1:1 propensity score-matching (PSM), patients were matched to the novel technique group and the conventional group, 109 cases in each group. The conventional group adopted a preoperative design based on a full-length radiograph (FLX) and received TKA with conventional osteotomy instruments. The novel technique group used a CT-based patient-specific 3D preoperative design combined with conventional osteotomy instruments; during the surgery, the femoral entry point, femoral valgus osteotomy angle, the fix point of tibial plateau extramedullary guide pin, and the position of tibial extramedullary positioning rod were accurately selected according to the preoperative 3D design to ensure accurate intraoperative implementation. The lower limb alignment, component position, operation time, tourniquet time, hospital stay, blood loss volume, incidence of postoperative complications, visual analog scale (Vas) score, and New Knee Society Score System (NEW-KSS) at 1 day before operation and 1, 6, and 12 months after operation were recorded and compared. Results The novel technique group was significantly better than the conventional group in controlling lateral tibial component angle (LTC) (P < 0.001), and the novel technique group had lower percentages of hip-knee-ankle angle (HKA) outliers (P < 0.001) and overcorrection (P = 0.003). The operation time, tourniquet time, and hospital stay of the novel technique group was shorter (P < 0.05). In 1 month after the operation, the novel technique group achieved a significantly better VAS score (P < 0.05), but a similar NEW-KSS score (P > 0.05) when compared with the conventional group. But in 6 and 12 months after surgery, no statistical differences were seen in the above two scores (P > 0.05). Conclusion The novel technique of CT-based patient-specific 3D preoperative design combined with conventional instruments can improve the accuracy of osteotomy in primary total knee arthroplasty, with benefits of significantly reducing pain and rapid recovery during the early postoperative period, but having no obvious effect on outcome after a 1-year follow-up.https://doi.org/10.1186/s13018-020-02123-5Total knee arthroplastyPropensity score matchingThree-dimensionalAlignmentVASKSS |
| spellingShingle | Kai Lei Li Ming Liu Yi Xiang Xin Chen Hua Quan Fan Yang Peng Jiang Ming Luo Lin Guo Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysis Journal of Orthopaedic Surgery and Research Total knee arthroplasty Propensity score matching Three-dimensional Alignment VAS KSS |
| title | Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysis |
| title_full | Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysis |
| title_fullStr | Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysis |
| title_full_unstemmed | Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysis |
| title_short | Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty: a propensity score-matched analysis |
| title_sort | clinical value of ct based patient specific 3d preoperative design combined with conventional instruments in primary total knee arthroplasty a propensity score matched analysis |
| topic | Total knee arthroplasty Propensity score matching Three-dimensional Alignment VAS KSS |
| url | https://doi.org/10.1186/s13018-020-02123-5 |
| work_keys_str_mv | AT kailei clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis AT limingliu clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis AT yixiang clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis AT xinchen clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis AT huaquanfan clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis AT yangpeng clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis AT jiangmingluo clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis AT linguo clinicalvalueofctbasedpatientspecific3dpreoperativedesigncombinedwithconventionalinstrumentsinprimarytotalkneearthroplastyapropensityscorematchedanalysis |