Abstract:

Objective To investigate the application of 3D printing osteotomy guide plate for multi⁃radius prosthesis total knee arthroplasty（TKA）in patients with severe knee osteoarthritis（KOA）and its influence on surgical trauma and joint function. Methods A total of 123 patients with severe KOA in our hospital from February 2019 to February 2021 were selected and divided into a control group（n = 61）and an observation group（n = 62） by a random number table. The control group received multi⁃radius prosthesis TKA ，and the observation group received multi ⁃ radius prosthesis TKA under the 3D printing osteotomy guide plate. The surgical conditions and complications of the two groups were recorded，and the surgical trauma indicators of the two groups［interleukin⁃1β （IL⁃1β），cortisol（Cor），creatine kinase（CK）］，pain mediators［substance P（SP），Prostaglandin E2（PEG2）， β⁃endorphin（β⁃EP）］，joint function（HSS），knee joint range of motion，lower limb force line angle were com⁃ pared. Results The operative time of the observation group was shorter than that of the control group，the intraop⁃ erative blood loss was less than that of the control group，and the postoperative 24 h VAS score was lower than that of the control group（P < 0.05）；On the 5th postoperative day，the serum levels of IL⁃1β，Cor and CK in the observation group were lower than those in the control group（P < 0.05）；Serum β⁃EP in the observation group was higher than that in the control group，and the levels of PEG2 and SP were lower than those in the control group （P < 0.05）；HSS scores，knee range of motion，and angle of lower limb lines of force in the 2 groups at 1 month and 3 months after operation were higher than those before operation（P < 0.05）；The complication rate of the observation group was 1.61% lower than that of the control group（14.75%，P < 0.05）. Conclusion 3D printing osteotomy guide plate has a definite effect on multi⁃radius prosthesis TKA in severe KOA patients，which could reduce intraoperative blood loss，relieve pain，shorten operative time，reduce complications，and has less impact on surgical inflammatory stress.

Key words:

severe knee osteoarthritis, 3D printed osteotomy guide plate, multi ? radius prosthesis, total knee arthroplasty, surgical trauma