关键词: 3D打印截骨导板； 全踝关节置换术； 踝关节炎； 加速康复外科

Abstract: Objective To observe the clinical efficacy of personalized 3D printed osteotomy guide plate assisted total ankle arthroplasty in the treatment of ankle osteoarthritis.Methods From January 2021 to January 2024, 42 patients with ankle osteoarthritis who underwent total ankle arthroplasty (TAA) were analyzed retrospectively.Divided into two groups according to the surgical method: the guide plate group (24 cases) used personalized 3D printed osteotomy guide plates made before surgery, simulated osteotomy before surgery, and assisted osteotomy during surgery.The traditional group (18 cases) used standard osteotomy guides provided by the manufacturer to locate and perform osteotomy with the assistance of X-ray fluoroscopy.The operation time, intraoperative blood loss, incision length, X-ray fluoroscopy times, pain degree 48 hours after operation, addition of analgesics, hospitalization time and incidence of complications were compared between the two groups, and compare the postoperative ankle joint function recovery between two groups of patients.Results In the guide plate group, the operation time was (78.50±9.96)min, the intraoperative blood loss was (168.08±36.86)ml, the incision length was (10.92±1.28)cm, the times of X-ray fluoroscopy were (6.58±1.59), the VAS score of postoperative pain was (3.33±0.76), the number of analgesic supplements was (2.08±0.97), and the hospitalization time was (8.67±1.63) days, all of which were less than those in the traditional group[(119.78±18.01)min, (230.78±34.77)ml, (12.78±1.44)cm, (14.33±2.28)times, (4.89±0.90), (3.78±0.81) and (11.67±1.81)d], with statistical significance (P<0.05).There were 4 cases of B-class healing in the guide plate group and 6 cases in the traditional group, there was no significant difference between the two groups (P>0.05), and no complications such as incision infection occurred in the two groups.Three months, six months and one year after operation, the ankle joint function of the two groups was significantly improved (P<0.05).Three months after operation, the average ankle function score of both groups reached a good level.From 6 months to 1 year after operation, the ankle joint function scores (Kofoed score) of the two groups all reached excellent level, and there was no significant difference in ankle joint function scores between the two groups (P<0.05).Conclusion In this study, based on 3D printing technology, personalized 3D printing osteotomy guide was made and pre-operation planning was carried out for patients, and TAA was assisted to complete, which achieved excellent clinical efficacy, making TAA more accurate, safe and feasible in the treatment of ankle arthritis.

Key words: 3D printed osteotomy guide; total ankle arthroplasty; ankle osteoarthritis; enhanced recovery after surgery