控制股骨假体旋转的新型3 D打印技术对全膝关节置换术中股骨髓内引导准确性的影响  

Effect of a novel 3D printing technology controlling rotation of femoral component on accuracy of femoral intramedullary guidance in total knee arthroplasty

作　　者：李云靖 段军富 孙超 赵自彪 王博 王艳铭 LI Yunjing;DUAN Junfu;SUN Chao;ZHAO Zibiao;WANG Bo;WANG Yanming(Department of Orthopedics,Hebi People's Hospital,Hebi,Henan 458030,China)

机构地区：[1]鹤壁市人民医院骨科,河南鹤壁458030

出　　处：《中国医学工程》2022年第4期76-79,共4页China Medical Engineering

摘　　要：目的探究控制股骨假体旋转的新型3D打印技术对全膝关节置换术(TKA)股骨髓内引导准确性的影响。方法选取2018年2月至2020年12月于鹤壁市人民医院骨科接受治疗的50例膝关节终末期骨关节炎(OA)患者,采用随机数字表法分为观察组22例与对照组28例。观察组在患者专用器械(PSI)辅助下进行TKA治疗,对照组进行常规TKA治疗。对比两组和组内的术前和术后6个月的临床结果。结果观察组手术时间高于对照组(P<0.05);观察组排水体积、髓内导深度、术后髌骨横轴-股骨上髁轴角(PFA)、术后后髁角(PCA)均低于对照组(P<0.05)。观察组的术后髋-膝-踝角(HKA)、特种外科医院膝关节评分(HSS)、美国膝关节协会膝关节评分(AKS)均高于术前(P<0.05);观察组的术后PFA低于术前(P<0.05)。对照组的术后HKA、HSS、AKS均高于术前(P<0.05);对照组的术后PFA低于术前(P<0.05)。结论PSI辅助TKA的短期临床疗效与常规TKA相似,可以更准确地辅助髓内引导和对齐股骨旋转。【Objective】To explore the effect of a novel 3D printing technology that controls the rotation of femoral components on the accuracy of femoral intramedullary guidance in total knee arthroplasty(TKA).【Methods】Fifty patients with knee end-stage osteoarthritis(OA)treated in the Department of Orthopedics of Hebi People's Hospital from February 2018 to December 2020 were randomly divided into 22 cases in the observation group and 28 cases in the control group.The observation group was treated with TKA with the aid of a patient-specific instrument(PSI),and the control group was treated with conventional TKA.The clinical results between the two groups and within the group were compared before and 6 months after the operation.【Results】The operation time of the observation group was higher than that of the control group(P<0.05);the drainage volume,intramedullary guide depth,postoperative PFA,and postoperative PCA of the observation group were lower than those of the control group(P<0.05).The postoperative HKA,HSS and AKS of the observation group were higher than those before the operation(P<0.05);the postoperative PFA of the observation group was lower than that before the operation(P<0.05).The postoperative HKA,HSS and AKS of the control group were higher than those before the operation(P<0.05);the postoperative PFA of the control group was lower than that before the operation(P<0.05).【Conclusion】The short-term clinical efficacy of PSIassisted TKA is similar to that of conventional TKA,and it can more accurately assist in intramedullary guidance and alignment of femoral rotation.

关 键 词：3D打印 髓内引导 患者专用器械 旋转对线 外科经髁轴 全膝关节置换术 

分 类 号：R687.4[医药卫生—骨科学]