3D打印技术辅助成人DDH初次THA的髋臼置入  

3D printing technique for placement of acetabular component of primary total hip arthroplasty in adult developmental dysplasia of the hip

作　　者：周金[1] 刘炯[1] 杨砥[1] 陈春[1] 肖坤[1] 吴凯峰 杨杰 

机构地区：[1]贵阳市第四人民医院,贵阳550002

出　　处：《中国矫形外科杂志》2017年第23期2182-2186,共5页Orthopedic Journal of China

摘　　要：[目的]运用3D打印技术对成人发育性髋关节发育不良(developmental dysplasia of the hip,DDH)初次行人工全髋关节置换术(total hip arthroplasty,THA)的患者制定术前计划,探讨该技术对髋臼杯置入的作用。[方法]纳入贵阳市第四人民医院骨一科2015年1月~2016年12月收治的成人DDH患者38例(41髋),其中,3D组19例(20髋),常规组19例(21髋),3D组患者术前根据打印3D模型三维重建数据制定术前计划;常规组按常规计划完成手术方案设计。术后比较髋臼假体外展角、前倾角,水平及垂直距离与术前预计值的差异程度,评估髋臼假体的置入精度。[结果]两组间髋臼实际位置,包括外展角、前倾角、水平及垂直距离的差异均有统计学意义(P>0.05)。3D组外展角、前倾角、水平及垂直距离的设计值和实际值差异度更小,更接近理想设计值。[结论]运用3D打印技术指导完成术前计划虽不能降低手术难度,但能优化术前设计,利于髋臼假体理想放置,增加假体置入精确度。[Objective] To evaluate the significance of 3D printing technique for the placement of acetabular cup of primary total hip arthroplasty （THA） in the adult with developmental dysplasia of the hip （DDH）. [Methods] From January 2015 to December 2016, 38 adult patients （41 hips） with DDH underwent THA in The Fourth People＇s Hospital of Guiyang. Of them, 19 pa- tients （20 hips） who had acetabular component placed by assistance of 3D printing technique were termed as the 3D group, while the remaining 19 patients （21 hips） who had conventional placement of acetabular component were named the routine group. The position of the acetabular component inserted, including abduction angle, anteversion angle, the horizontal distance and the vertical distance were compared between the two groups. [Results] There were significant differences in actual position of acetabularprosthesis placement, including abduction angle, anteversion angle, horizontal distance and vertical distance, between the two groups （P〈O.05）. Compared to the routine group, the 3D group had significantly decreased differences between the preoperative designed values and the postoperative actual values in abduction angle, anteversion angle, horizontal distance and vertical distance of the acetabular components. [Conclusion] Although use of 3D printing technique to guide placement of acetabular component does not reduce the difficulty of surgery, it does optimize the preoperative design, increase the accuracy of prosthesis placement at the ideal position in operation.

关 键 词：3D打印技术 全髋关节置换术 发育性髋关节发育不良 

分 类 号：R687.4[医药卫生—骨科学]