膝关节置换3D打印个性化手术工具临床应用专家共识(2023年版)

Expert consensus on clinical application of 3D printed patient-specific instrumentation for total knee arthroplasty(2023)

全膝关节置换术(TKA)是治疗终末期膝骨关节疾病的有效手段,术中截骨的精准度是影响TKA术后疗效的重要因素。3D打印个性化手术工具,可以在计算机辅助下进行PSI术前三维设计和个性化定制,术中代替传统工具进行个性化的截骨导向辅助,减少手术步骤,降低了由于手术经验、测量误差等原因导致的截骨失准和术后力线不良,提高了TKA术后的下肢力线优良率,有利于患者术后功能改善和满意度提高。因此,PSI靠其精准、便捷、个性化等特点,现已广泛用于常规人工膝关节置换领域。然而,目前缺少PSI在人工膝关节置换领域临床应用的指引性规范。本共识以现有文献证据为基础,对PSI在人工膝关节置换的临床应用进行评价,通过共识性推荐意见对PSI在当前主题领域的使用做出指导性意见。

Total knee arthroplasty(TKA)is an effective method for treating end-stage knee osteoarthritis,and the accuracy of osteotomy is an important factor affecting the postoperative efficacy of TKA.3D printed patient-specific instrumentation(PSI)is designed and customized by computer technology preoperatively.During surgery,traditional tools are replaced with PSI to preform osteotomy procedure,resulting in higher accuracy of alignment,which may can improve postoperative function and satisfaction.Therefore,PSI has been widely used in total knee arthroplasty due to its precise,convenient,and personalized characteristics.However,there is currently a lack of guiding standards for the clinical application of PSI for TKA.On the basis of evidence-based medicine,the proposed consensus will provide the indications,preoperative design,intraoperative principles and perioperative managements of PSI for TKA.