Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide ...Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography （CT） images of the knee.Methods： From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People＆#39;s Hospital were divided into a guide plate group （GPG, 21 cases） and a traditional surgery group （TSG, 21 cases） using a random number table method.In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation.TSG cases were treated with the conventional method.Outcomes were obtained from the postoperative image examination and short-term follow-up.Results： Operative time was 49.0 ＆#177; 10.5 min for GPG, and 62.0 ＆#177; 9.7 min in TSG.The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ＆#177; 1.7＆#176;, 89.0 ＆#177; 1.1＆#176;, 6.6 ＆#177; 1.4＆#176;, and 0.9 ＆#177; 0.3＆#176; in GPG, and 86.7 ＆#177; 2.9＆#176;, 87.6 ＆#177; 2.1＆#176;, 8.9 ＆#177; 2.8＆#176;, and 1.7 ＆#177; 0.8＆#176; in TSG, respectively.The Hospital for Special Surgery scores 3 months after surgery were 83.7 ＆#177; 18.4 in GPG and 71.5 ＆#177; 15.2 in TSG.Statistically significant differences were found between GPG and TSG in all measurements.Conclusions： A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images.This allows for shorter operative times and better postoperative alignment than the traditional surgery.Application of the digital guide plate may also result in better short-term outcomes.展开更多
文摘Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography （CT） images of the knee.Methods： From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People＆#39;s Hospital were divided into a guide plate group （GPG, 21 cases） and a traditional surgery group （TSG, 21 cases） using a random number table method.In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation.TSG cases were treated with the conventional method.Outcomes were obtained from the postoperative image examination and short-term follow-up.Results： Operative time was 49.0 ＆#177; 10.5 min for GPG, and 62.0 ＆#177; 9.7 min in TSG.The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ＆#177; 1.7＆#176;, 89.0 ＆#177; 1.1＆#176;, 6.6 ＆#177; 1.4＆#176;, and 0.9 ＆#177; 0.3＆#176; in GPG, and 86.7 ＆#177; 2.9＆#176;, 87.6 ＆#177; 2.1＆#176;, 8.9 ＆#177; 2.8＆#176;, and 1.7 ＆#177; 0.8＆#176; in TSG, respectively.The Hospital for Special Surgery scores 3 months after surgery were 83.7 ＆#177; 18.4 in GPG and 71.5 ＆#177; 15.2 in TSG.Statistically significant differences were found between GPG and TSG in all measurements.Conclusions： A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images.This allows for shorter operative times and better postoperative alignment than the traditional surgery.Application of the digital guide plate may also result in better short-term outcomes.
