基于国产3D打印TTM垫块重建髋臼骨缺损的临床研究  

Reconstruction of acetabular bone defects with domestic 3D printed TTM pad

作　　者：乔登朝 王少华[2] 魏瑄[2] 汪文录 秦建英 陈晓磊 李征 Qiao Dengchao;Wang Shaohua;Wei Xuan;Wang Wenlu;Qin Jianying;Chen Xiaolei;Li Zheng(Henan Second Provincial People’s Hospital,Xinzheng 451191,China;Department of Arthrology,Zhengzhou Orthopedic Hospital,Zhengzhou;Graduate School,Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南省第二人民医院,新郑451191 [2]郑州市骨科医院关节科,郑州450000 [3]河南中医学院研究生院,郑州450000

出　　处：《中国实用医刊》2023年第12期9-13,共5页Chinese Journal of Practical Medicine

基　　金：河南省科技攻关项目(182102310463)。

摘　　要：目的探讨采用国产3D打印钛合金骨小梁金属(TTM)垫块联合生物型臼杯重建髋臼骨缺损的效果。方法回顾性分析2015年3月至2018年7月郑州市骨科医院收治的45例(45髋)髋关节重建髋臼骨缺损患者的临床资料。按照髋臼重建方法将患者分成TTM垫块组(22例,22髋)和植骨组(23例,23髋)。TTM垫块组通过术前3D打印构建模型,实施模型手术预演,选用合适的TTM垫块联合生物型臼杯完成重建和假体安置;植骨组选用生物型臼杯联合同种异体骨进行髋关节重建。术后所有患者均按时随访,随访时间12~30个月,平均19.46个月。记录两组患者手术前后髋关节功能及并发症发生情况,应用影像学检查观察假体骨长入情况及髋关节旋转中心位置变化。结果末次随访时,TTM垫块组Harris髋关节功能评分及视觉模拟评分法(VAS)评分[(92.90±4.46)、(1.09±0.52)分]均高于植骨组[(84.56±2.88)、(2.21±0.59)分],P均<0.05。末次随访时,TTM垫块组髋臼旋转中心与泪滴连线的垂直距离和泪滴与髋关节旋转中心的水平距离均优于植骨组(P均<0.05)。末次随访影像学检查结果显示,TTM垫块组假体与宿主骨交界处骨长入良好。结论对髋臼骨缺损采用国产3D打印TTM垫块联合生物型臼杯重建,初始稳定性及骨长入良好,髋关节旋转中心和髋关节功能恢复良好,并发症少。ObjectiveTo investigate the clinical effect of domestic 3-dimentional(3D)printed titanium trabecular metal(TTM)pad combined with biological acetabular cup in reconstruction of acetabular bone defects.MethodsThe clinical data of 45 patients(45 hips)who underwent hip joint reconstruction for acetabular bone defects in Zhengzhou Orthopedic Hospital from March 2015 to July 2018 were retrospectively analyzed.According to methods of reconstruction of acetabular bone defects,the patients were divided into TTM pad group(22 patients,22 hips)and bone graft group(23 patients,23 hips).The models used in the TTM pad group were constructed by 3D printing before operation,and the model operation rehearsal was performed to select appropriate TTM pad and biological acetabular cup for reconstruction and prosthesis placement.The bone graft group was treated by hip reconstruction with biological acetabular cup combined with allograft bone.After the operation all patients were timely followed up for 12-30 months,with an average of 19.46 months.The preoperative and postoperative function of the hip joint and the complications in the two groups were recorded.The prosthesis bone ingrowth and the changes of the rotation center of the hip joint were observed by imaging examination.ResultsAt the last follow-up,the Harris hip joint function score and visual analogue scale(VAS)score of the TTM pad group(92.90±4.46,1.09±0.52)were higher than those of the bone graft group(84.56±2.88,2.21±0.59),all P<0.05.At the last follow-up,the vertical distance from the acetabular rotation center to the teardrop line and the horizontal distance from the teardrop to the hip joint rotation center in the TTM pad group were superior to those in the bone graft group(all P<0.05).The imaging examination results at the last follow-up showed that the bone ingrowth at the junction between the prosthesis and the host bone was good in the TTM pad groups.ConclusionsDomstic 3D printed TTM pad combined with biological acetabular cup has good initial stability and bone

关 键 词：髋臼 骨缺损 3D打印钛金骨小梁属假体 临床效果 

分 类 号：R687.3[医药卫生—骨科学]