应用3D打印技术治疗假性软骨发育不全双膝骨性关节炎1例  

A patient with pseudoachondroplasia undergoing bilateral total knee arthroplasties using three-dimensional printing technology

作　　者：许志庆[1] 张怡元[1] 王武炼[1] 

机构地区：[1]厦门大学附属福州市第二医院,福建省福州市350001

出　　处：《中国组织工程研究》2017年第27期4360-4365,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:假性软骨发育不全是一种罕见的遗传性骨病,这类患者由于骨骼畸形、韧带松弛、骨骼小等系列骨骼并发症造成全膝关节置换手术复杂及充满挑战。目的:探讨应用3D打印技术治疗假性软骨发育不全患者双膝骨性关节炎的疗效。方法:对1例假性软骨发育不全患者应用3D打印技术行双全膝关节置换的诊疗过程进行回顾性总结分析,X射线观察双膝置换后假体位置,并进行膝关节KSS评分。结果与结论:①患者双膝置换后双下肢站立位全长X射线片显示:假体位置及双下肢力线良好。1年后复查X射线显示:假体位置良好,胫骨截骨处骨折线消失;②置换后右膝KSS临床评分94分,功能评分90分,活动度:95°-0°-0°;左膝KSS临床评分93分,功能评分90分,活动度:90°-0°-0°;患者对手术效果非常满意;③结果说明,应用3D打印技术治疗可以根据个体需求进行个体化治疗,降低手术难度,提高手术操作准确性,减少手术副损伤,利于患者恢复;同时矫正畸形,获得良好的手术效果及患者满意度。BACKGROUND： Pseudoachondroplasia is rare heredigary osteopathy, usually accompanied by deformity of the lower limbs, short fingers, and ligamentous laxity, so it is a difficulty in total knee arthroplasty.OBJECTIVE： To evaluate the curative effectiveness of bilateral total knee arthroplasties for a patient with pseudoachondroplasia using three-dimensional （3D） printing technology.METHODS： A retrospective study was done in a case of pseudoachondroplasia undergoing bilateral total knee arthroplasties using 3D printing technology. X-ray examination was conducted to observe the prosthesis location after arthroplasties, and the Knee Society Score outcome measures were used to evaluate the functional outcome.RESULTS AND CONCLUSION： （1） After arthroplasties, X-rays showed good line of force of the lower limbs and prosthesis location, and 1 year later, showed no radiolucent lines in tibia. （2） The right Knee Society Score improved to 94 points, the functional scoring improved to 90 points, and the postoperative flexion was 95°; the left Knee Society Score improved to 93 points, the functional scoring improved to 90 points, and the postoperative flexion was 90°. All patients were very satisfied with the treatment outcomes. （3） These results indicate that the individualized treatment scheme designed using 3D printing technology can reduce the surgical difficulty and trauma with high accuracy, and promote the functional recovery of the knee. Additionally, it obtains good clinical efficacy and patient＇s satisfaction in orthopaedic surgeries.

关 键 词：骨科植入物 数字化骨科 3D打印技术 假性软骨发育不全 膝骨性关节炎 遗传性骨病 

分 类 号：R318[医药卫生—生物医学工程]