3D打印截骨导板在重度膝骨性关节炎患者多半径假体全膝关节置换术中的应用效果  

Application of 3D printing osteotomy guide plate for multi-radius prosthesis total knee arthroplasty in patients with severe knee osteoarthritis and its effect on surgical trauma and joint function

作　　者：吴迪[1] 司丽娜[2] 武丽珠 王建华[1] 罗金伟 常乾坤 吕永明[1] 杨阳[1] WU Di;SI Li′na;WU Lizhu;WANG Jianhua;LUO Jinwei;CHANG Qiankun;LÜYongming;YANG Yang(Affiliated Hospital of Chengde Medical College,Chengde 067000,China;不详)

机构地区：[1]承德医学院附属医院,河北承德067000 [2]承德医学院,河北承德067000 [3]承德市中心医院,河北承德067000

出　　处：《实用医学杂志》2022年第2期190-195,共6页The Journal of Practical Medicine

基　　金：承德市科学技术研究与发展计划项目(编号:202109A034)。

摘　　要：目的探讨3D打印截骨导板在重度膝骨性关节炎(knee osteoarthritis,KOA)患者多半径假体全膝关节置换术(total knee arthroplasty,TKA)中的应用效果及对手术创伤、关节功能的影响。方法选取2019年2月至2021年2月我院123例重度KOA患者,随机数字表法分为对照组(n=61)和观察组(n=62)。对照组行多半径假体TKA,观察组行3D打印截骨导板下多半径假体TKA。观察两组手术情况、并发症,比较两组手术创伤指标[白细胞介素-1β(IL-1β)、皮质醇(Cor)、肌酸激酶(CK)]、疼痛介质[P物质(SP)、前列腺素E2(PEG2)、β-内啡肽(β-EP)]、关节功能(HSS)、膝关节活动度、下肢力线角度。结果 (1)观察组手术时间短于对照组,术中失血量少于对照组,术后24 h VAS评分低于对照组(P <0.05);(2)术后5 d,观察组血清IL-1β、Cor、CK水平低于对照组(P <0.05);(3)术后1个月观察组血清β-EP高于对照组,PEG2、SP水平低于对照组(P <0.05);(4)术后1、3个月两组HSS评分、膝关节活动度、下肢力线角度高于术前(P <0.05);(5)观察组并发症发生率低于对照组(1.61%vs. 14.75%,P <0.05)。结论 3D打印截骨导板在重度KOA患者多半径假体TKA中效果确切,可减少术中出血量,缓解疼痛,缩短手术时间,降低并发症,且手术炎症应激影响较小。Objective To investigate the application of 3D printing osteotomy guide plate for multi-radius prosthesis total knee arthroplasty(TKA)in patients with severe knee osteoarthritis(KOA)and its influence on surgical trauma and joint function. Methods A total of 123 patients with severe KOA in our hospital from February2019 to February 2021 were selected and divided into a control group(n = 61)and an observation group(n = 62)by a random number table. The control group received multi-radius prosthesis TKA,and the observation group received multi-radius prosthesis TKA under the 3 D printing osteotomy guide plate. The surgical conditions and complications of the two groups were recorded,and the surgical trauma indicators of the two groups[interleukin-1β(IL-1β),cortisol(Cor),creatine kinase(CK)],pain mediators[substance P(SP),Prostaglandin E2(PEG2),β-endorphin(β-EP)],joint function(HSS),knee joint range of motion,lower limb force line angle were compared. Results The operative time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that of the control group,and the postoperative 24 h VAS score was lower than that of the control group(P < 0.05);On the 5 th postoperative day,the serum levels of IL-1β,Cor and CK in the observation group were lower than those in the control group(P < 0.05);Serum β-EP in the observation group was higher than that in the control group,and the levels of PEG2 and SP were lower than those in the control group(P < 0.05);HSS scores,knee range of motion,and angle of lower limb lines of force in the 2 groups at 1 month and 3 months after operation were higher than those before operation(P < 0.05);The complication rate of the observation group was 1.61% lower than that of the control group(14.75%,P < 0.05). Conclusion 3D printing osteotomy guide plate has a definite effect on multi-radius prosthesis TKA in severe KOA patients,which could reduce intraoperative blood loss,relieve pain,shorten operative time,reduce complications,and has le

关 键 词：重度膝骨性关节炎 3D打印截骨导板 多半径假体 全膝关节置换术 手术创伤 

分 类 号：R816.8[医药卫生—放射医学]