3D打印截骨模具辅助下开放楔形胫骨高位截骨术治疗内翻性膝骨关节炎早期疗效分析  

The Open-wedge High Tibial Osteotomy Assisted by 3D Printing Osteotomy Model for Varus Osteoarthritis of Knee: A Short-term Effect Analysis

作　　者：赵大鹏[1] 宫林海[1] 张晓涛[1] 朴宁 ZHAO Da-peng;GONG Lin-hai;ZHANG Xiao-tao;PIAO Ning(Department of Orthopedics,General Hospital of Benxi Iron,Liaoning Health Industry Group,Benxi 117000,Liaoning,China)

机构地区：[1]辽宁健康产业集团本钢总医院骨科

出　　处：《中国现代手术学杂志》2019年第5期338-344,共7页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨3D打印截骨模具辅助下开放楔形胫骨高位截骨术治疗内翻性膝骨关节炎的早期临床疗效及优势。方法回顾性分析我院2016年5月~2018年5月收治的膝内翻畸形合并内侧单间室骨关节炎改变的39例患者的临床资料,均行开放楔形胫骨高位截骨术,其中应用3D打印截骨模具辅助截骨(3D打印模具组)19例,常规方法截骨(常规截骨组)20例。记录并比较两组患者手术时间、术中透视次数、术后并发症、术前及术后3个月HSS评分、VAS评分、MPTA、FTA及胫骨平台后倾角。结果两组患者术后切口均一期愈合,无明显并发症。3D打印模具组手术时间、术中透视次数均低于常规截骨组,差异具有统计学意义(P<0.05)。两组患者术后3个月的FTA、MPTA、VAS、HSS评分均较术前明显改善,差异具有统计学意义(P<0.05);术后胫骨后倾角较术前轻度减少,但差异无统计学意义(P>0.05)。组间比较,两组患者术前及术后FTA、MPTA、HSS评分、VAS评分及胫骨平台后倾角比较,差异均无统计学意义(P>0.05)。结论3D打印截骨模具辅助下开放楔形胫骨高位截骨术治疗内翻性膝关节骨关节炎可获得满意的早期临床疗效,同时可简化手术步骤,避免反复透视和多次截骨操作,节省手术时间,为术中精确截骨提供了一种简单、有效的辅助方法。Objective To explore the early efficacy of open-wedge high tibial osteotomy(OWHTO)assisted by 3D printing osteotomy mould in the treatment of varus osteoarthritis of the knee.Methods A total of 39 cases with genu varus and osteoarthritis performed OWHTO were enrolled in the retrospective analysis admitted from May 2016 to May 2018,including of 19 cases received osteotomy assisted by 3 D printing osteotomy model(as 3D printing model group)and 20 cases underwent conventional osteotmy(as conventional osteotomy group).The operating time,intraoperative fluoroscopy times,postoperative complications,HSS score,Visual analogue scale(VAS),medial proximal tibial angle(MPTA),femora-tibial angle(FTA)and tibia slope angle was compared.Results The incision was healed without serious complications in both groups.The operation time and intra-operative fluoroscopy times were less in the 3D printing model group than those in the conventional osteotomy group,and the differences were significant statistically(P<0.05).The FTA,MPTA,VAS and HSS scores were improved at 3 months after surgery than before the surgery in both groups,and the differences were statistically(P<0.05).Although the tibia slope angle was slightly reduced after the surgery,but there was no statistical difference between the post-and pre-operative tibia slope angle in both groups(P>0.05).No statistical differences was found in FTA,MPTA,HSS,VAS and tibia slope angle after the surgery between the two groups(P>0.05).Conclusions The surgery of OWHTO assisted by 3D printing osteotomy model can achieve satisfied short-term result for correction of varus osteoarthritis of knee.It could simplify the operation procedures,avoid repeated X-ray radiation and multiple osteotomy,shorten the operation time,and provide an simple and effect technique for accurate osteotomy.

关 键 词：3D打印技术 胫骨高位截骨术 膝内翻 骨关节炎 

分 类 号：R682.6[医药卫生—骨科学] R687.31[医药卫生—外科学]