【摘要】 目的 探讨3D打印个性化截骨导板（PSI）在全膝关节置换术（TKA）中的应用效果，并分析其对髌骨高度、关节线位置及术后膝关节功能恢复的影响。方法 收集2023年1月至2024年1月滨州医学院附属烟台山医院骨科的128例TKA患者病例资料，按照截骨工具的不同分为PSI组（67例患者采用3D打印个性化的PSI）和传统组（61例采用传统器械），比较两组手术相关指标、疼痛、髌骨高度、关节线位置及膝关节功能。结果 PSI组手术操作时间相较于传统组更短（P<0.05）,PSI组术中出血量和术后引流量相较于传统组更少（P<0.05）。术后1、7、14d，两组VAS较术前降低（P<0.05），但PSI组VAS相较于传统组差异无统计学意义（P>0.05）。PSI组Insall-Salvati、CatonDeschamps指数手术前后差值相较于传统组更低（P<0.05）,PSI组关节线高度手术前后差值相较于传统组差异无统计学意义（P>0.05）。术后6、12个月，两组HSS升高（P<0.05），且PSI组HSS相较于传统组更高（P<0.05）。结论 3D打印个性化PSI应用于TKA患者中，可缩短手术操作时间，减少术中出血量和术后引流量，减少对髌骨高度的影响，促进膝关节功能恢复，但对术后疼痛的减轻与对关节线位置的保持无优势。更多还原

【Abstract】 Objective Explore the application effect of 3D printed personalized osteotomy guide(PSI) in total knee arthroplasty(TKA), and postoperative knee joint function recovery.Methods 128 TKA patients from January 2023 to January 2024 were selected in Department of Orthopedics,Yantai Affiliated Hospital of Binzhou Medical University and divided into PSI group(n=67, 3D printed personalized PSI) and traditional group(n=61, traditional instruments) according to different bone cutting tools. The surgical related indicators, pain, patellar height, joint line position, and knee joint function were compared between the two groups. Result The PSI group had shorter surgical time compared to the traditional group(P<0. 05), and the PSI group had less intraoperative bleeding and postoperative drainage compared to the traditional group(P<0. 05). On postoperative 1, 7, and 14 days, the VAS of both groups decreased(P<0. 05), and the VAS of the PSI group compared with the traditional group had no statistical significance(P>0. 05). The difference in Insall Salvati and Caton Deschamps indices before and after surgery in the PSI group was lower than that in the traditional group(P<0. 05), and the difference in joint line height before and after surgery in the PSI group was not statistically significant compared to the traditional group(P>0. 05). The HSS of both groups increased at 6 months and 12 months after surgery(P<0. 05), and the HSS of the PSI group were higher than those of the traditional group(P<0. 05). Conclusions The application of 3D printed personalized PSI in TKA patients can reduce surgery time, intraoperative bleeding and postoperative drainage, minimize the impact on patellar height, and promote knee joint function recovery. However, it has no advantage in reducing postoperative pain and maintaining joint line position.更多还原