3D打印截骨导板在膝关节单髁置换术中的应用  

Application of 3D-printed Osteotomy Guide Plate in Unicompartmental Knee Arthroplasty

作　　者：顾飞 姚庆强[1,2] 刘帅[1,2] 李佳怡[1,2] 张惠康[2] 徐燕 王黎明[1] GU Fei;YAO Qing-qiang;LIU Shuai;无(不详;Department of Orthopaedics,Nanjing Hospital Affiliated to Nanjing Medical University,Institute of Digital Medicine,Nanjing Medical University,Nanjing 210006,Jiangsu Province,P.R.C.)

机构地区：[1]南京医科大学附属南京医院骨科,江苏省南京市210006 [2]南京医科大学数字医学研究所,江苏省南京市210006 [3]连云港市第二人民医院,江苏省连云港市222000

出　　处：《中国数字医学》2020年第6期97-100,共4页China Digital Medicine

基　　金：南京市2018年度科技发展计划项目(编号:201805001)。

摘　　要：目的:研究3D打印个性化截骨导板辅助膝关节单髁置换在临床应用中的疗效及安全性。方法:2018年7月至2019年3月期间,初次单侧膝关节单髁置换(UKA)患者18例,男性5例,女性13例。术前将患者膝关节的CT及MRI数据导入计算机进行混合配准重建膝关节骨与软骨复合结构,然后利用计算机软件进行测量及模拟截骨,设计并3D打印个性化截骨导板并应用在术中指导手术。术后对比两组患者之间髋膝踝角(hip and knee,HKA)、平均手术时间、术后48 h引流量、术后3个月膝关节HSS评分。结果:18例患者的手术平均时间、术后48 h引流量均获得较为满意的效果,术后患肢力线较术前明显改善、术后3个月膝关节HSS评分较术前评分明显改善。结论:基于CT和MRI混合配准的PSI-UKA技术可以获得良好的术前计划与手术精度,术后下肢力线满意,并可缩短手术时间,减少术后出血量,早期术后膝关节功能可以得到明显改善,该技术的远期疗效尚需要进一步研究。Objective:To investigate the efficacy and the safety of Three-dimensional printed patient specific instruments(PSIs)in Unicompartmental knee arthroplasty(UKA).Methods:Data of this retrospective study were collected from 18 patients(5 males and 13 females)who underwent UKA From July 2018 to March 2019 in our department.Preoperative CT and MRI data of the knee were imported into the computer for hybrid registration and for the design of PSIs,preoperative planning and surgical simulation.Whereafter,the solid model and the PSI were printed and applied in real surgical operation.Patients'demographics,surgery duration,postoperative drainage,the axial alignment of the lower extremity and HSS scores were recorded and analyzed.Results:The surgical duration and postoperative drainage of 18 patients were satisfactory.Compared with the preoperative status,the lower limb axial alignment and the HSS score was significantly improved after operation.Conclusion:The 3D printed PSI based on CT and MRI registration was associated with encouraging efficacy in the management of UKA,leading to the reduction in surgical duration and postoperative drainage,the improvement on lower limb axial alignment and functional recovery in the early postoperative period.However,further study is still necessary to evaluate the long-term effect of this technology.

关 键 词：膝内侧间室骨关节炎 个性化截骨导板 单髁膝关节置换 

分 类 号：R319[医药卫生—基础医学] R684