新型3D打印个体导向器在膝关节置换中的应用  

Novel individually designed 3D printed guiders for total knee arthroplasty

作　　者：杨滨[1] 张克[1] 袁亮 孙彬 辛星[1] 刘新光[1] 王晓华 YANG Bin;ZHANG Ke;YUAN Liang;SUN Bin;XIN Xing;LIU Xin-guang;WANG Xiao-hua(Department of Orthopedics,International Hospital,Peking University,Beijing 102206,China)

机构地区：[1]北京大学国际医院,北京市102206

出　　处：《中国矫形外科杂志》2021年第1期75-78,共4页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:11502014);北京大学国际医院院内科研基金项目(编号:YN2019ZD05);中国科协青年人才托举工程项目(编号:YESS 2015QNRC001)。

摘　　要：[目的]介绍新型3D打印个体化导向器在全膝关节置换术中的手术技术和初步临床效果。[方法]2016年10月~2018年12月,采用新型3D打印个体化导向器行全膝关节置换36例。术前行CT薄层扫描,重建整个下肢的三维立体模型,然后确定股骨和胫骨侧力线,模拟膝关节截骨和假体的置入,打印个性化导向器。术中将个性化导向器分别于股骨骨面和胫骨骨面贴附稳固后,在导向器截骨槽引导下截骨,并安装人工关节假体。[结果]所有患者均顺利手术,无严重并发症。WOMAC评分由术前(50.53±16.62)分显著减少至末次随访时(13.53±7.39)分(P<0.05);KSS临床评分由术前(53.68±21.79)分显著增加至末次随访时(82.79±9.63)分(P<0.05);KSS功能评分由术前(48.63±20.19)分显著增加至末次随访时(75.23±9.78)分(P<0.05)。影像方面,36例患者胫股角由术前(168.03±6.42)°显著增加至末次随访时(177.10±2.51)°,差异有统计学意义(P<0.05)。[结论]新型3D打印个体化导向器在全膝关节置换假体安装型号及位置精确,取得良好的临床疗效。[Objective]To introduce the surgical technique of novel individually designed 3D printed guiders for total knee arthroplas⁃ty.[Methods]From October 2016 to December 2018,36 patients underwent total knee arthroplasty by using the novel individually de⁃signed 3D-printed guiders.After CT slice scanning,the 3D model of the total low extremity was created.The anatomic landmarks were marked,then femoral and tibial alignments were determined on the models.Subsequently,mimic osteotomy and prosthetic placement were performed on the 3D models to design a individual guiders based on the osteotomy sites,size and orientation of the prostheses.The individu⁃al guiders made by 3D printing were intraoperatively used for femoral and tibial osteotomy and prosthetic installation.[Results]All the 36 patients had operation performed smoothly without serious complications.The WOMAC score significantly decreased from(50.53±16.62)before operation to(13.53±7.39)at the latest follow-up(P<0.05).However,the KSS clinical score significantly increased from(53.68±21.79)preoperatively to(82.79±9.63)at the final interview(P<0.05),and the KSS functional score significantly increased from(48.63±20.19)before operation to(75.23±9.78)at the latest follow-up(P<0.05).[Conclusion]The novel individually designed 3D printed guiders facilitated to conducted TKA precisely and simply,achieve satisfactory clinical results.

关 键 词：3D 打印 个体化导向器 全膝关节置换术 

分 类 号：R687.4[医药卫生—骨科学]