应用3D打印辅助胫骨高位截骨技术对下肢力线矫正的疗效  

Effect of high tibial osteotomy assisted by 3D printing model for lower limb alignment

作　　者：戴云清 李征[1] 安帅[1] 曹光磊[1] Dai Yunqing;Li Zheng;An Shuai;Cao Guanglei(Department of orthopaedics,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院骨科,100053

出　　处：《骨科临床与研究杂志》2023年第6期336-340,362,共6页Journal Of Clinical Orthopedics And Research

摘　　要：目的对比3D打印导板辅助胫骨高位截骨技术与传统手术方式对于术后下肢力线矫正的精准性。方法回顾分析2016年6月至2021年1月首都医科大学宣武医院骨科收治的膝内翻骨性骨性关节炎患者共计61例(64膝);分为3D打印组(43膝)和传统手术组(21膝)。比较两组术前规划与术后的下肢力线(WBL)绝对差及其可接受范围程度、胫骨近端内侧角(MPTA)、胫骨平台后倾角(PTS)、手术时长和术后并发症。结果两组患者一般资料差异无统计学意义。两组术后各有1例伤口渗出。3D打印组合页点骨折4例;传统手术组5例。3D打印组WBL绝对差(3.7±2.9)小于传统手术组(7.3±5.9)(P=0.01)。3D打印组WBL可接受范围程度(81.4%)显著高于传统手术组(52.4%)。3D打印组MPTA绝对差值(2.5±1.8)少于传统手术组绝对差值(5.1±3.0)(P=0.01)。两组术前和术后PTS比较差异均无统计学意义。结论3D打印导板辅助胫骨高位截骨术和传统手术技术相比,所得术后下肢力线与术前规划更为接近,具有更高的精准性。Objective To compare the accuracy of high tibial osteotomy assisted by 3D printing model with traditional surgical methods for postoperative orthopedic of weight bearing line.Methods The clinical data of total of 61 patients(64 knees)with varus osteoarthritis of the knee admitted to Department of orthopaedics,Xuanwu Hospital of Capital Medical University from June 2016 to January 2021,were retrospectively analyzed.They were divided into the 3D printing group(43 knees)and the traditional surgery group(21 knees).The absolute difference of weight bearing line(WBL),acceptable range of WBL,medial proximal tibial angle(MPTA)and posterior tibial slope(PTS),operation time and postoperative complications were compared between the two groups.Results There was no statistical difference in the general information between the two groups.Postoperative wound exudation occurred in 1 case in each group.There were 4 cases of lateral hinge fractures in 3D printing and 5 cases in traditional operation group.The absolute difference of WBL in 3D printing group(3.7±2.9)was less than that in traditional surgery group(7.3±5.9)(P=0.01).In the acceptable range of WBL,the 3D printing group(81.4%)was significantly higher than the traditional surgery group(52.4%).The absolute difference of MPTA in 3D printing group(2.5±1.8)was less than that in traditional surgery group(5.1±3.0)(P=0.01).There was no significant difference in preoperative and postoperative PTS between the two groups.Conclusions Compared with traditional surgical techniques,the postoperative weight bearing line obtained by 3D printing model assisted high tibial osteotomy is more similar to the preoperative planning,with higher accuracy.

关 键 词：胫骨 截骨术 3D打印 

分 类 号：R68[医药卫生—骨科学]