Open wedge supramalleolar osteotomy versus 3D printing patient-specific guides for varus ankle osteoarthritis: A retrospective case control study

Abstract

Purpose Degenerative joint disease (DJD) of the ankle is a chronic disease that can severely limit function and cause debilitating pain, and with the development of digital medicine, 3D printing patient-specific instrumentation has been used in many subjects. The purpose of the study was to compare the clinical and radiographic outcomes of 3D-printed patient-specific guides with the traditional open- wedge supramalleolar osteotomy . Materials and methods We retrospectively analyzed 10 patients with varus ankle osteoarthritis treated by open wedge supramalleolar osteotomy via 3D patient-specific instrument (PSI group) and 14 patients treated via the traditional method (control group). The demographic data and the pre- and post-operative TAS, TT, TLS angle were recorded. The AOFAS and VAS score were acquired pre-operatively and at the last follow-up time. Results All patients were obtained after surgery 49.4 ± 8.3 months (36–62) follow-up. The TAS, TT, TLS angle and VAS, AOFAS score was comparable pre-operatively between two groups(p＞0.05). The VAS and AOFAS score was statistically improved at the last follow-up time in both cohorts. And the TAS angle was significantly increased post-operatively in the overall cohort. The TT,TLS angle was also ameliorated, though insignificantly. The intraoperative fluoroscopy time, estimated blood loss, and operating time was statistically less in the PSI group in the two cohorts. The post-operative TAS, TT, TLS angle and VAS, AOFAS score at the last follow-up time was comparable between the two cohorts. Conclusion 3D-printed patient-specific guides have a short operation time, low intraoperative blood loss and less fluoroscopy frequency. Patient-specific guides can assist in facilitating doctor-patient communication, shortening the learning curve, reducing surgery time, and correcting varus deformity accurately. And the functional outcome was non-inferior to the traditional method.