个性化3D打印导向器在全髋关节置换术中的辅助作用  

A personalized 3D printing guide in total hip arthroplasty

作　　者：刘效仿[1] 周观明[1] 余海波[1] 管明强[1] 侯朝辉 刘礼初[1] Liu Xiaofang;Zhou Guanming;Yu Haibo;Guan Mingqiang;Hou Zhaohui;Liu Lichu(Department of Orthopaedics,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院骨科,528000

出　　处：《中华创伤骨科杂志》2019年第12期1059-1063,共5页Chinese Journal of Orthopaedic Trauma

基　　金：广东省科技计划项目(2017B090904002);佛山市科学技术局科技创新项目(2017AG100041)。

摘　　要：目的探讨个性化3D打印导向器在人工全髋关节置换术(THA)中的辅助作用。方法回顾性分析2018年1月至2019年5月期间佛山市中医院骨十科行人工THA治疗的60例股骨头缺血性坏死患者资料。根据是否使用个性化3D导向器分为两组:导向器组30例,男17例,女13例;年龄为(53.4±8.9)岁;常规组30例,男19例,女11例;年龄为(54.7±9.4)岁。髋臼假体安放角度以外展角40°、前倾角15°为目标。比较两组患者的术中出血量、手术时间及髋臼假体外展角等。结果两组患者的性别、年龄、体重、病因及股骨头缺血性坏死Ficat分期等术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。导向器组患者的术中出血量[(286.7±150.8)mL]显著少于常规组患者[(438.3±292.6)mL],手术时间[(90.5±34.4)min]也显著少于常规组患者[(115.6±58.6)min],差异均有统计学意义(P<0.05)。导向器组和常规组患者的髋臼杯外展角分别为38.9°±4.2°、37.2°±5.5°,差异无统计学意义(t=1.315,P=0.194)。结论个性化3D打印导向器应用于人工THA能够缩短髋臼假体安装时间,减少术中出血量;但是术后髋臼杯外展角与未使用个性化3D打印导向器的患者无明显差异。Objective To explore the role of a customized 3D printing guide in total hip arthroplasty(THA).Methods A retrospective analysis was performed of the 60 patients who had been treated by THA for avascular necrosis of the femoral head at Department of Orthopaedics and Traumatology,Foshan Hospital of Traditional Chinese Medicine from January 2018 to May 2019.Half of them used the personalized 3D printing guide in THA and half did not.In the guide group there were 17 men and 13 women with an age of 53.4±8.9 years while in the conventional group 19 men and 11 women with an age of 54.7±9.4 years.The acetabular cups were orientated at an abduction angle of 40°and an anteversion angle of 15°.The intraoperative blood loss,operation time and acetabular abduction angle were compared between the 2 groups.Results The 2 groups were comparable due to insignificant differences between them in gender,age,body mass,cause of disease or staging of avascular necrosis of the femoral head(P>0.05).The guide group had significantly less intraoperative blood loss(286.7±150.8 mL)and operation time(90.5±34.4 min)than the conventional group did(438.3±292.6 mL and 115.6±58.6 min)(P<0.05).The acetabular cup abduction was 38.9°±4.2°in the guide group and 37.2°±5.5°in the conventional group,showing no significant difference(t=1.315,P=0.194).Conclusion Use of a personalized 3D printing guide in THA can shorten the time for installation of an acetabular prosthesis and reduce the amount of intraoperative blood loss,but it leads to insignificant difference in the postoperative acetabular cup abduction compared with no use of the guide.

关 键 词：关节成形术 置换 髋 3D打印技术 导向器 

分 类 号：R687[医药卫生—骨科学]