3D打印技术辅助髋臼旋转截骨术的疗效分析与思考  

Curative effect analysis and thinking of 3D printing technology assisted rotational acetabular osteotomy

作　　者：徐文南 梁庆威[1] 李旭[1] 范广宇[1] 姚鲁田[1] Xu Wennan;Liang Qingwei;Li Xu;Fan Guangyu;Yao Lutian(Department of Orthopedics,The First Hospital of China Medical University Shenyang Liaoning,110001,China)

机构地区：[1]中国医科大学附属第一医院骨科

出　　处：《生物骨科材料与临床研究》2019年第5期24-30,共7页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的分析3D打印技术辅助髋臼旋转截骨术(rotational acetabular osteotomy,RAO)的疗效。方法 对2012年3月至2018年2月收治的42例髋臼发育不良患者(42髋)施行髋臼旋转截骨术(RAO)。所有病例均为女性,平均年龄36.1岁,平均随访时间13.4个月。按照术前是否使用3D打印模型分为3D打印组和非3D打印组,分别测量两组术前、3D打印组术后及非3D打印组术后的外侧中心边缘角(lateral central-edge angle,LCE)、Sharp 角、臼顶倾斜角(T?nnis角)、髋臼覆盖率、旋转中心下移程度和手术时间,采用医院术后并发症情况统计量表记录两组患者术后并发症的发生情况,并进行比较。结果 3D打印组与非3D打印组术后测量的LCE角、髋臼覆盖率、并发症发生率及手术时间比较,差异有统计学意义(P<0.05)。与非3D打印组相比,3D打印组上述指标的结果更符合正常髋关节的影像学数据。在骨盆模型上进行预操作,可以提前发现术中可能遇到的困难,有效减少术中发育异常髋臼对确定截骨线和截骨角度的干扰等问题。结论 3D打印技术辅助髋臼旋转截骨术有助于提高截骨的精确性及安全性,降低手术难度,缩短手术时间。Objective To assess the effect of 3 D printing technique in rotational acetabular osteotomy.Methods A total of42 acetabular dysplasia patients(42 hips) were treated by rotational acetabular osteotomy(RAO) with 3 D printing model which included 42 females from March 2012 to February 2018.The patients with an average age of 36.1 years were followed up for an average of 13.4 months.All patients were divided into 3 D printing group and non-3 D printing group according to whether used 3 D printing model before operation.The parameters of LCE(lateral central-edge angle)angle,Sharp angle,Tonnis angle,rate of acetabular coverage,rotation center down degree and surgery time were compared before and after the operation.The occurrence of postoperative complications in the two groups were recorded by the hospital postoperative complications statistics scale.Results There were significant differences(P<0.05) in postoperative LCE angle,acetabular coverage,complication rate and operation time between the 3 D printing group and non-3 D printing group.Compared with the non-3 D printing group,above outcomes were more consistent with the normal hip imaging index in 3 D printing group.Pre-operation on the pelvic model can find the difficulties that may be encountered in the operation,and effectively reduced the interference of dysplastic acetabular in the determination of osteotomy line and osteotomy angle,etc.Conclusion The application of 3 D printing model in RAO can indeed improve the accuracy and safety of acetabular osteotomy with shorten time and facilitation.

关 键 词：髋臼发育不良 髋臼旋转截骨术 3D打印 

分 类 号：R687.3[医药卫生—骨科学]