Total Knee Arthroplasty Using Virtual Prototyping and Additive Manufacturing

The aim of the study was to evaluate clinical and radiological outcomes of total knee arthroplasty using patient-specific guides to position cutting blocks manufactured by means of virtual prototyping and 3D printing.

Materials and Methods. During the period from 2016 to 2018, six surgeries in total knee arthroplasty were performed at the Institute of Traumatology and Orthopedics of Privolzhsky Research Medical University (Nizhny Novgorod, Russia) using patient-specific precision guides to position cutting blocks. The indication for these surgical operations in patients was the presence of post-traumatic knee joint osteoarthrosis of stage III (according to the classification of N.S. Kosinskaya).

Simulation of surgery on a virtual prototype of the lower limb provided the possibility to carry out quantitative analysis of the following parameters: deformity angles, resection depth, and direction, the size of endoprosthesis components.

Results. The attempt to normalize the lower limb axis proved to be successful in all patients. The anatomical femorotibial angle was 176.1±2.56° after surgery, the deviation from the limb axis was 0.45±0.46° according to FLFS. In the period from 6 to 12 months after surgery, the average KOOS score was 91.2±10.1° for Pain; 83.45±12.70° for Daily Physical Activity; 71.1±15.23° for Symptoms and Stiffness; 73.10±16.1° for Quality of Life. The average range of motion in the knee joint after total knee arthroplasty was 105.2±10.9° in flexion and there was full extension. In 4 patients, the data on positioning the cutting blocks corresponded to computer navigation data. In 2 cases, the deviation of the femoral patient-specific precision guide in the frontal plane was 1–3°, in the tibial plane — 2–4°.

The implant size was found to correspond to the results of preoperative planning on computer 3D models in all patients.

Conclusion. Total knee arthroplasty using a virtual three-dimensional prototype of the patient’s lower limb and 3D printing allowed achieving good and excellent clinical and radiological results.

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Gorbatov R.O., Malyshev E.E., Romanov A.D., Karyakin N.N. Total Knee Arthroplasty Using Virtual Prototyping and Additive Manufacturing. Sovremennye tehnologii v medicine 2018; 10(3): 146, https://doi.org/10.17691/stm2018.10.3.18