Clinical application of 3D printing technology and digital simulation in one-stage surgery for peri-knee fractures combined with anterior cruciate ligament rupture
TU Junbo
LI Xingwang
HUANG Xiaowu
LI Cuihe
Abstract：Objective To explore the application effect of digital simulation combined with 3D printing technology in one-stage surgery for peri-knee fractures combined with anterior cruciate ligament(ACL)rupture.Methods Clinical data of 14 patients with peri-knee fracture and ACL rupture admitted to Xinfeng County People's Hospital,Jiangxi Province from January 2019 to June 2023 were retrospectively analyzed.All patients underwent preoperative 64-slice CT and MRI examinations.Imaging data were utilized for 3D fracture model reconstruction and simulated reduction using Mimics software,followed by making a patient-specific fracture model via 3D printing technology,which guiding preoperative planning of internal fixation strategies and bone tunnel positioning for ACL reconstruction.Then single-stage procedure,open reduction and internal fixation(ORIF)with arthroscopic ACL reconstruction was performed in all cases.Results All 14 patients completed the surgery successfully.The operation time was 85 to 162 min,with the average of 125.2 min.The intraoperative bleeding volume was 50 to 180 mL,with the average of 70.1 mL.Six months after surgery anterior drawer tests were all negative,while grade Ⅰ laxity on Lachman test was observed in one patient.Anatomical reduction was achieved in all fractures.The healing time of fracture was 3 to 6 months,with the average of 3.9 months.At the last follow-up,the average visual analog scale score at the last follow-up was 0.86 points(0-4 points),the average Hospital for Special Surgery score was 87.8 points(68 to 94 points),with an excellent and good rate of 92.8%.No surgical related complications such as nerve or vascular injuries,compartment syndrome were found during and after the operation.During the follow-up period,no internal fixation fracture,loosening,failure or fracture displacement occurred,and no adverse events of infection around the internal fixator had happened.Conclusions The integration of digital simulation with 3D printing-assisted surgery could provide a safe and feasible strategy in one-stage treatment for peri-knee fracture combined with ACL rupture due to precise preoperative plan of internal fixation and ligament reconstruction pathways as well as effective prevention of tunnel collision,with less operation time and better postoperative functional recovery.
Keywords：Knee jointFractureAnterior cruciate ligament injuriesPrintingthree-dimensionalDigital technology
Publication Date：2025-02-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 25-29 )