Research Article
Orthopedic Implants
Application of 3D Printed Personalized Osteotomy Guides Combined with Custom Plates in Open Wedge High Tibial Osteotomy
Background: The use of 3D printed personalized osteotomy guides in open wedge high tibial osteotomy for treating knee osteoarthritis offers advantages such as shorter surgical time, fewer fluoroscopy instances, and higher correction accuracy. However, previously reported osteotomy guides have significant issues, including severe damage to surrounding soft tissues and improper positioning of locking plates.Objective: To explore the clinical efficacy of 3D printed personalized osteotomy guides combined with custom plates in assisting open wedge high tibial osteotomy for knee osteoarthritis.Methods: A total of 20 patients diagnosed with knee osteoarthritis were collected and divided into a 3D group and a conventional group, with 10 cases in each group. The 3D group underwent open wedge high tibial osteotomy assisted by 3D printed personalized osteotomy guides combined with custom plates, while the conventional group underwent standard open wedge high tibial osteotomy. The surgical time, fluoroscopy instances, incision length, preoperative and postoperative hip-knee-ankle angles, proximal medial tibial angles, posterior tibial angles, and the difference between planned correction angles and actual correction angles were analyzed and compared. Additionally, knee joint range of motion and Lysholm scores were recorded at 1, 3, and 6 months postoperatively, along with any complications.Results and Conclusion: ① The surgical time and fluoroscopy instances in the 3D group were significantly lower than those in the conventional group (P < 0.001); ② Both groups showed a significant increase in postoperative hip-knee-ankle angles and proximal medial tibial angles compared to preoperative values (P < 0.001), while there was no significant change in posterior tibial angles; the differences between planned and actual values for hip-knee-ankle angles, proximal medial tibial angles, and posterior tibial angles in the 3D group were (-0.22±0.72)°, (-0.20±0.73)°, and (0.23±0.37)°, respectively, with no significant differences; the difference between planned and actual correction degrees in the 3D group was smaller than that in the conventional group, with significant differences (P < 0.05); ③ Both groups showed a gradual increase in knee joint range of motion and Lysholm scores postoperatively (P < 0.001); the 3D group had better knee joint range of motion at 1 and 3 months postoperatively and better Lysholm scores at 1 month postoperatively compared to the conventional group, with significant differences (P < 0.05); there were no significant differences in Lysholm scores at 3 months and knee joint range of motion and Lysholm scores at 6 months postoperatively (P > 0.05); ④ No complications occurred in either group; ⑤ The results indicate that both the 3D printed personalized osteotomy guides combined with custom plates and the conventional methods have good clinical efficacy, but the former has shorter surgical times, fewer fluoroscopy instances, and faster recovery of knee joint function; furthermore, 3D printed personalized osteotomy guides can accurately achieve preoperative planning.
Chinese Journal of Tissue Engineering Research Publication Focus: Artificial Joints; Bone Implants; Spine; Fractures; Internal Fixation; Digital Orthopedics; Tissue Engineering
Keywords: 3D Printing, Personalized Osteotomy Guides, Custom Plates, Open Wedge High Tibial Osteotomy, Knee Osteoarthritis
Citation: Ma Chi, Wang Ning, Chen Yong, Wei Zhi Han, Liu Feng Ji, Park Cheng Zhe. Application of 3D Printed Personalized Osteotomy Guides Combined with Custom Plates in Open Wedge High Tibial Osteotomy. [J]. Chinese Journal of Tissue Engineering Research, 2025, 29(9): 1863-1869.
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https://www.cjter.com/CN/10.12307/2025.124
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