目的 分析3D打印个性化截骨导板在内翻膝患者膝关节双间室置换术中的临床应用效果。 方法 选取80例终末期内翻膝关节骨性关节炎且接受膝关节双间室置换术（TKA）的患者，随机分为2组，其中传统手术组40例（40膝），3D打印导板组40例（40膝）。分别记录2组手术时长、术中出血量、术后首次下床时间、术后股骨与胫骨机械轴夹角、VAS评分、膝关节HSS评分、WOMAC评分、膝关节活动度（ROM）等指标并统计分析。 结果 所有患者均顺利实施手术并接受随访3 ~ 12个月。与传统手术组相比，3D打印导板组手术时长显著缩短（P < 0.05），术中出血量、术后首次下床时间明显缩短（P < 0.05），术后VAS评分、股骨与胫骨机械轴夹角低于传统手术组（P < 0.01）。2组术后6个月KSS评分明显高于术前（P < 0.01），术后6个月3D打印导板组KSS评分高于传统手术组（P < 0.05），2组KSS评分差异无统计学意义（P > 0.05）。2组患者术后3个月、6个月WOMAC评分较术前均随着时间的推移而降低（P < 0.05），术后3个月、6个月，3D打印导板组评分低于传统手术组（P < 0.05）。除传统手术组出现积血感染1例，经再次清创后保存假体顺利出院外，所有手术患者未出现神经血管损伤、深静脉栓塞、假体松动、假体周围骨折等并发症。 结论 基于3D打印截骨导板行膝关节置换术，较传统TKA手术具有手术操作时间短、失血量少、截骨精确快捷、术后恢复快、就诊满意度高等优点，临床疗效更具有优势。

Objective To evaluate the clinical efficacy of a rapid 3D-printed patient-specific osteotomy guide in knee replacement surgery， and provide guidance for its widespread clinical application. Methods A total of 80 patients with end-stage knee osteoarthritis who had undergone Total Knee Arthroplasty （TKA） were selected and randomly divided into two groups. The first group comprised 40 cases （40 knees） that underwent traditional TKA， while the second group consisted of 40 patients （40 knees） in the 3D-printed osteotomy guide group. Various parameters， including surgery duration， intraoperative blood loss， time to ambulation after surgery， mechanical axis angle between femur and tibia post-surgery， Visual Analog Scale （VAS） score， Hospital for Special Surgery （HSS） knee score， Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） score， range of motion （ROM） of the knee， and other indicators were analyzed separately for both groups. Statistical analyses were conducted. Results All the patients underwent surgery smoothly and were followed up for 3 ~ 12 months. In comparison to the traditional osteotomy guide group， the 3D-printed osteotomy guide group demonstrated significantly shorter surgery duration （P < 0.05）， reduced intraoperative blood loss， earlier time to first ambulation after surgery （P < 0.05）， lower postoperative VAS score， and smaller mechanical axis angle between the femur and tibia after surgery （P < 0.01）. At 6 months post-surgery， both groups showed significantly improved KSS scores compared to preoperative values （P < 0.01）. The KSS score of the 3D-printed guide group was higher than that of the traditional surgical guide group at 6 months after surgery （P < 0.05）， but there was no statistical difference in KSS scores between the two groups （P > 0.05）. WOMAC scores for both groups decreased over time at 3 and 6 months post-surgery compared to preoperative scores （P < 0.05）. At these time points， WOMAC scores were lower in the 3D-printed guide group than in the traditional osteotomy guide group （P < 0.05）. One case of hematocele and infection occurred in the traditional osteotomy guide group； however， successful discharge was achieved following re-debridement while preserving the prosthesis. None of the surgical patients experienced complications such as neurovascular injury， deep vein thrombosis， prosthesis loosening or periprosthetic fractures. Conclusion Compared to conventional total knee arthroplasty （TKA） surgery， the utilization of a rapid 3D-printed osteotomy guide for knee replacement presents several advantages， including reduced surgical operation duration， minimal intraoperative blood loss， precise and expeditious osteotomies， accelerated postoperative recovery， and heightened patient satisfaction during medical consultations. Notably， its clinical efficacy surpasses that of traditional approaches.