基于3D打印技术行全膝关节置换治疗内翻畸形膝骨性关节炎  

Three-dimensional printing technology-aided total knee arthroplasty for osteoarthritis with genu varum deformity

作　　者：孙振国[1] 朱佳俊[1] 崔岩[1] 倪胜辉[1] 张治宇[1] 

机构地区：[1]中国医科大学附属第四医院骨科,辽宁省沈阳市110032

出　　处：《中国组织工程研究》2017年第15期2395-2399,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:传统全膝关节置换因其复杂的髓内定位技术、过度依赖术者经验截骨而广为诟病,在3D打印技术辅助下行全膝关节置换能够更加精确的进行定位、截骨。目的:比较在3D打印技术辅助下行全膝关节置换治疗膝内翻畸形与传统治疗方案临床疗效的差异。方法:收集接受初次单侧全膝关节置换治疗膝内翻畸形患者的临床资料34例,采用随机数字表法分为2组,每组17例。其中一组患者在3D打印截骨导板辅助下行全膝关节置换治疗(3D打印组);另外一组患者接受传统全膝关节置换治疗(常规组)。记录2组患者出血量(包括术中出血量及术后引流量)、手术时间,关节置换后2周时美国特种外科医院(Hospital for Special Surgery,HSS)膝评分、膝关节活动度及股骨与胫骨机械轴夹角。结果与结论:(1)3D打印组关节置换后2周膝关节活动范围大于常规组,但差异无显著性意义(P=0.744);(2)3D打印组关节置换后2周HSS膝关节评分2组差异无显著性意义(P=0.532);(3)置换后股骨与胫骨机械轴夹角,2组差异无显著性意义(t=0.218,P=0.632);(4)3D打印组手术时间较常规组显著缩短(P=0.000);(5)3D打印组出血量较常规组显著减少(P=0.000);(6)结果表明,应用3D打印截骨导板辅助行全膝关节置换后2周膝关节活动范围、HSS评分及下肢力线恢复情况无显著差异,但具有手术时间短,出血量少,截骨更精确等优点,更适合于高龄、基础状态差、创伤承受能力小,要求迅速完成手术的患者。BACKGROUND： The complicated localization of intramedullary nails and osteotomy more dependent on surgeons＆#39; experience limit the application of conventional total knee arthroplasty （TKA）. The occurrence of three-dimensional （3D） printing technology can achieve precise localization and osteotomy in TKA.OBJECTIVE： To explore the effectiveness of 3D printing technology-aided TKA versus conventional TKA for genu varum.METHODS： Thirty-four patients with genu varum undergoing primary unilateral TKA were recruited and were then divided into two groups （n=17 per group） in accordance with the random number table. One group was treated with TKA with 3D printing guild plate （3D printing group）, while the other group received the conventional TKA （conventional group）.The intraoperative and postoperative blood loss, operation time, as well as the Hospital for Special Surgery score, range of motion, and lower limb mechanical alignment at 2 weeks postoperatively were compared between two groups.RESULTS AND CONCLUSION： （1） The range of motion of knee in the 3D printing group was larger than that in the conventional group, but had no significant difference at 2 weeks postoperatively （P=0.744）. （2） There was no significant difference in the Hospital for Special Surgery scores between two groups at 2 weeks postoperatively （P= 0.532）. （3） The postoperative lower limb mechanical alignment showed no significant difference between two groups （t=0.218, P=0.632）.（4） The operation time in the 3D printing group was significantly shorter than that in the conventional group （P=0.000）. （5） The blood loss in the 3D printing group was significantly less than that in the conventional group （P=0.000）. （6） Our findings indicate that 3D printing technology-aided TKA exhibits similar results to the conventional TKA in the Hospital for Special Surgery scores, range of motion, and lower limb mechanical alignment, but it shortens the operation time,reduces the blood loss, and

关 键 词：关节成形术 置换 膝 骨关节炎 膝内翻 组织工程 骨科植入物 人工假体 3D打印 人工全膝关节置换 

分 类 号：R318[医药卫生—生物医学工程]