3D打印聚醚醚酮假体在肩胛骨肿瘤切除术后骨缺损重建中的价值  

Value of 3D printed polyether ether ketone prosthesis in the treatment of scapular tumors

作　　者：康建平 肖砚斌 李文忠 张漾杰 肖渝 朱昱衡 王寒 陈国平 田昌平 李鹍 陈英涛 Kang Jianping;Xiao Yanbin;Li Wenzhong;Zhang Yangjie;Xiao Yu;Zhu Yuheng;Wang Han;Chen Guoping;Tian Changping;Li Kun;Chen Yingtao(Department of Orthopaedic Surgery,Yunnan Cancer Hospital(the Third Affiliated Hospital of Kunming Medical University),Kunming 650118,China;Department of Imaging,Yunnan Cancer Hospitalthe(the Third Affiliated Hospital of Kunming Medical University),Kunming 650118,China;School of Physics and Astronomy,Yunnan University,Kunming 650091,China)

机构地区：[1]云南省肿瘤医院(昆明医科大学第三附属医院)骨外二科,昆明650118 [2]云南省肿瘤医院(昆明医科大学第三附属医院)影像科,昆明650118 [3]云南大学物理与天文学院,昆明650091

出　　处：《中华骨科杂志》2023年第10期665-669,共5页Chinese Journal of Orthopaedics

基　　金：云南省科技厅-云南大学"双一流"联合基金(2019FY003031)。

摘　　要：聚醚醚酮(polyetheretherketone,PEEK)作为一种新型热塑性工程塑料具有良好的生物活性、弹性模量与人体皮质骨相近和射线可透性等优点,已广泛应用于医学领域。本文探讨使用3D打印个性化PEEK材料修复肩胛骨骨肿瘤切除术后骨缺损的安全性及临床疗效。2020年1月至2021年12月在云南省肿瘤医院采用肿瘤切除3D打印PEEK肩胛骨假体重建治疗肩胛骨肿瘤6例,男3例、女3例,年龄14~52岁,滑膜肉瘤1例、Ewing肉瘤1例、软骨肉瘤4例。术前通过CT数据设计、制作PEEK假体;术中在确保安全外科边界的前提下进行肿瘤切除用假体置换,其中全肩胛骨假体置换2例、部分肩胛骨假体置换4例。手术时间为90~170 min,出血量为100~400 ml。6例患者均获得随访,肿瘤无进展生存时间为16~28个月,未见肿瘤复发和转移,全部患者均无瘤生存。末次随访时,Constant-Murley肩关节评分最低为62分,最高为68分;日本骨科协会肩关节评分最低为63分,最高为78分。3D打印PEEK材料假体置换在肩胛骨肿瘤保肢治疗中具有一定的优势,其质量轻、适配好、安装相对简单、组织相容性较好,术后可以获得较好的肩关节外观及功能,有望成为肩胛骨肿瘤保肢治疗的选择方案之一。Polyetheretherketone(PEEK)as a new type of thermoplastic engineering plastic,has good biological activity,elastic modulus close to human cortical bone and radiation permeability,and has been widely used in medical field.This study aims to explore the safety and clinical efficacy of using 3D printing personalized PEEK materials to repaire scapular bone defects after bone tumor resection.A total of 6 patients who underwent the implantation of 3D printed PEEK scapular prosthesis from January 2020 to December 2021 in Yunnan Cancer Hospital were retrospectively analyzed.There were 3 males and 3 females,with age ranged from 14 to 52 years.There were 1 case of synovial sarcoma,1 of Ewing's sarcoma,and 4 of chondrosarcoma.PEEK prosthesis was designed and fabricated based on CT data before surgery.Tumor resection and prosthesis replacement were performed under the premise of ensuring safe surgical boundaries,including 2 cases of total scapular prosthesis replacement and 4 cases of partial scapular prosthesis replacement.The operation time was 90-170 min,and the intraoperative blood loss was 100-400 ml.All 6 patients received satisfactory follow-up,with a tumor progression free survival time of 16-28 months.No tumor recurrence or metastasis was observed,and all patients survived tumor free.At last follow-up,the Constant-Murley shoulder joint score was a minimum of 62 points and a maximum of 68 points.The Japanese Orthopaedic Association's shoulder joint score was 63 points minimum and 78 points maximum.Computer-aided design 3D printing PEEK material prosthesis has certain advantages in the treatment of scapular tumor limb salvage.It has light weight,well adapted,relatively simple installation,good histocompatibility,and can obtain a better appearance and function of the shoulder joint after operation.It can become one of the options for limb salvage treatment of scapular tumor.

关 键 词：肩胛骨 聚醚醚酮假体 3D打印 骨重建 

分 类 号：R738.1[医药卫生—肿瘤]