个性化设计3D打印导板辅助全髋关节置换术临床研究  

Application of individualized 3D printed guide plates in total hip arthroplasty:A clinical study

作　　者：李绪辉 林勇 叶前驱 陈森荣 曾广辉 潘敏成 钟浩博 LI Xuhui;LIN Yong;YE Qianqu;CHEN Senrong;ZENG Guanghui;PAN Mincheng;ZHONG Haobo(The Third Affiliated Hospital,Guangdong Medical University,Foshan 528318,China;Guangdong Medical University,Zhanjiang 524023,China;Huizhou First People’s Hospital,Huizhou 516001,China)

机构地区：[1]广东医科大学附属第三医院//佛山市顺德区龙江医院,广东佛山528318 [2]广东医科大学,广东湛江524023 [3]惠州市第一人民医院,广东惠州516000

出　　处：《现代医院》2023年第8期1305-1308,共4页Modern Hospitals

摘　　要：目的介绍个性化设计3D打印导板辅助全髋关节置换术(THA)的临床应用方法,并探讨其效果及预后情况,为提高THA诊疗精准度提供可行参考方案。方法分析自2021年6月以来收治的20例全髋关节置换术患者治疗情况,其中男性11例,女性9例,年龄分布27~84岁,根据手术方式共分为两组,研究组13例,对照组7例。研究组采用数字三维测量评估、个性化设计3D打印技术进行术前手术设计规划并于术中利用导板精准引导实施THA,对照组为既往行传统THA病例。比较两组病例的手术时间、术中出血量,并在术后行X线片、CT扫描及三维模型测量,评估两组患者髋臼假体的前倾角和外展角、股骨假体前倾角、股骨偏心距、联合前倾角、双下肢长度等指标,比较两组患者术后效果。结果研究组的手术时间、术中出血量均显著低于对照组。术后通过影像学及三维评估表明术前个性化3D打印设计能够良好地预测患者手术所需假体规格,同时,研究组利用的人工髋关节导板有效地提高髋臼及股骨柄假体假体的放置准确度,并能够较佳地矫正患者术前的双下肢短缩(P<0.05)。结论对于常规尤其是存在部分下肢短缩的患者,在进行THA手术时,借助个性化设计3D打印导板引导技术能够有效地降低手术时间、术中出血量及提升假体的机体匹配度,提高肢体短缩的矫正率。Objective To investigate the effect of individualized 3D printed guide plates on assisting total hip arthroplasty so as to provide a applicable scheme for improving THA diagnosis and treatment accuracy.Methods This study retrospectively analyzed the treatment data of 20 patients admitted for total hip arthroplasty since June 2021.The patients,11 males and 9 females,aged between 27 to 84 years,were divided into two groups:a study group(n=13)anda control group(n=7).In the study group,digital 3D measurement and evaluation and individualized design 3D printing technology were used for preoperative surgical design,and precise intraoperative guidance through guide plates was used for THA,and in the control group the conventional THA was performed.The two groups were compared in terms of operative time and intraoperative bleeding.Postoperative radiographs,CT scans and 3D model measurements were performed to assess the anteversion and abduction angles of the acetabular prosthesis,femoral prosthesis anteversion angle,femoral eccentric distance,joint anteversion angle and length of both lower extremities in the two groups.Results The operative time and intraoperative bleeding in the study group were significantly lower than in the control group.Postoperative imaging and 3D assessment showed that the preoperative individualized 3D printing design could well predict the patient’s required prosthesis specifications for surgery,Moreover,the artificial hip guide plates utilized in the study group effectively improved the accuracy of acetabular and femoral stem prosthesis placement and improved the patient’s preoperative bilateral limb shortening more better compared to the control group(P<0.05).Conclusion This study suggests that the application of individualized 3D printed guide plates in the THA surgery can effectively reduce the operation time and intraoperative bleeding,enhance the body-prosthesis compatibility,and improve the correction rate of limb shortening for patients especially those with partial lower extremity

关 键 词：THA 个性化设计 三维重建 短缩畸形 3D打印技术 

分 类 号：R687.42[医药卫生—骨科学]