个性化3D打印导航模板在膝关节创伤性关节炎全膝关节置换术中的应用效果观察  

Application effect of personalized 3D printing osteotomy navigation template in total knee arthroplasty for treatment of knee traumatic osteoarthritis

作　　者：李锋侦 邹士平[1] 司文腾[1] 陈成亮[1] LI feng-zhen;ZOU Shi-ping;SI Wen-teng;CHEN Cheng-liang(Department of Joint Surgery,Zhengzhou City Orthopedics Hospital,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州市骨科医院关节病科,河南450052

出　　处：《中国骨与关节损伤杂志》2022年第2期130-133,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨个性化3D打印导航模板在膝关节创伤性关节炎全膝关节置换术中的应用效果。方法回顾性分析自2017-09—2019-09行全膝关节置换术治疗的31例膝关节创伤性关节炎,术前获取患者膝关节CT扫描数据,通过计算机软件模拟标准化手术程序,重建下肢力线,设计股骨远端截骨模板及胫骨平台截骨模板,通过3D打印机制作出患膝实物模型及截骨模板,术中采用个性化3D打印导航模板辅助截骨。结果31例术后均获得至少2年随访,随访期间膝关节活动度改善,疼痛症状缓解。术后复查X线片显示膝内翻畸形得到矫正,下肢力线恢复正常,膝关节假体位置良好。术后2年疼痛VAS评分、膝关节AKS评分、膝关节活动度、下肢机械力线角、股骨远端外侧角、胫骨平台近端内侧角、股骨外旋角均较术前明显改善,差异有统计学意义(P<0.05)。结论个性化3D打印导航模板应用于膝关节创伤性关节炎全膝关节置换术中可简化手术操作步骤,提高截骨精准性,从而获得良好的下肢力线。Objective To investigate the application effect of the personalized 3D printing osteotomy navigation template in total knee arthroplasty for treatment of knee traumatic osteoarthritis.Methods A retrospective analysis was performed of the 31 patients with knee traumatic osteoarthritis who had undergone TKA from September 2017 to September 2019.Preoperative CT scan data of knee were obtained,standardized surgical procedures were simulated by computer software and the lower limb axis was reconstructed,the distal femur osteotomy template and tibial plateau osteotomy template were also designed.Physical model of the patients knees and osteotomy template were made through 3D printing mechanism,3D printed personalized osteotomy template was used to assist osteotomy during surgery.Results All 31 patients were followed up for at least 2 years,during which the range of motion was improved and pain symptoms were relieved.Postoperative review of the X-ray film showed that the varus deformity was corrected,the mechanical axis of the lower limb returned to normal,and the implanted prosthesis were in good position.Two years after operation,VAS score,AKS score,range of motion,the HKA angle,the lateral angle of the distal femoral,the medial angle of the proximal tibia,as well as the external rotation angle of femur were increased significantly compared with those before operation,there were significant differences(P<0.05).Conclusion The application of personalized 3D printed navigation template in total knee arthroplasty for knee traumatic osteoarthritis can simplify surgical procedures and improve osteotomy accuracy,so as to obtain good mechanical alignment of lower limbs.

关 键 词：膝关节创伤性关节炎 全膝关节置换术 3D打印技术 截骨导板 

分 类 号：R687.42[医药卫生—骨科学]