摘要
目的探讨3D打印技术在成人髋关节发育不良继发骨性关节炎全髋关节置换术中的应用价值。方法纳入自2017-08—2020-02行全髋关节置换术治疗的40例成人髋关节发育不良继发骨性关节炎,观察组20例采用软件进行髋关节3D重建,进行术前规划,3D打印个性化导航模板辅助手术。对照组20例根据常规影像学资料进行术前规划并依靠经验完成术中操作。比较两组安装髋臼假体所用的手术时间,术中出血量,以及术后影像学测量数据与术前计划数据的差值。结果观察组安装髋臼假体手术时间较对照组短,术中出血量较对照组少,差异有统计学意义(P<0.05)。40例术后均获得至少18个月随访,无神经损伤、肺栓塞、深部感染、假体周围骨折、假体松动等并发症发生,无翻修患者。将术后影像学测量结果与术前计划方案相比较,观察组髋臼假体大小、外展角、前倾角、旋转中心垂直距离、旋转中心水平距离的差值明显小于对照组,差异有统计学意义(P<0.05)。结论采用3D打印技术辅助全髋关节置换术治疗成人髋关节发育不良继发骨性关节炎能简化手术流程,降低术中的不确定性,明显减少手术时间和术中出血,髋臼假体大小、位置、角度、骨包容性的预测准确性明显高于常规手术。
Objective To explore the application value of 3D printing technology in total hip arthroplasty(THA)surgery of development dysplasia of hip(DDH)with osteoarthritis.Methods Forty cases of DDH with osteoarthritis were selected for THA from August 2017 to February 2020,divided into observation group and control group.Among them,20 patients in the observation group were subjected to software for 3D reconstruction of the hip joint,followed by preoperative planning,and assisted by3D printed personalized navigation templates.The control group consisted of 20 patients,underwent preoperative planning based on conventional imaging data and intraoperative procedures based on experience.The operation time,intraoperative blood loss,and the difference between postoperative imaging measurements and preoperative planned data were compared between the two groups.Results The operation time of acetabular prosthesis installation in the observation group was shorter than that in the control group,and the intraoperative blood loss was less than that in the control group,with statistical significance(P<0.05).All the 40 patients were followed up for at least 18 months after surgery,and there were no neurological injury,pulmonary embolism,deep infection,periprosthetic fracture,prosthesis loosening and other complications,and no revision patients.Compared with the preoperative plan,the difference of acetabular prosthesis size,abductor angle,rake angle,vertical distance and horizontal distance of rotation center in the observation group were significantly smaller than those in the control group,with statistical significance(P<0.05).Conclusion 3D printing technology assisted THA of DDH with osteoarthritis can simplify the surgical process,reduce the uncertainty during surgery,significantly reduce the operative time and intraoperative bleeding,at the same time,the prediction accuracy of acetabular prosthesis size,position,angle,and bone inclusion is significantly higher than that of conventional surgery.
作者
赵资坚
张荣臻
蔡史健
钟志刚
ZHAO Zi-jian;ZHANG Rong-zhen;CAI Shi-jian;ZHONG Zhi-gang(Department of Orthopaedics,the Second People’s Hospital of Shantou,Shantou,Guangdong 515011,China)
出处
《中国骨与关节损伤杂志》
2022年第4期346-350,共5页
Chinese Journal of Bone and Joint Injury
基金
汕头市医疗卫生科技计划项目(汕府科[2018]11号)。
