三维打印截骨导板对膝关节置换平衡功能的影响  

The Efficacy of Three-Dimensional Printed Personalized Osteotomy Guide Technology on the Balance Function of Total Knee Arthroplasty

作　　者：凯沙尔·百合提亚尔 陈殿卿 张磊 努尔买买提·艾尼瓦尔 杨德勇[1] 舒莉[1] CAESAR Lilytyar;CHEN Dianqing;ZHANG Lei;NUERMAIMAITI Ainiwaer;YANG Deyong;SHU Li(Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,China;Affiliated Hospital of Hebei Chinese People's Armed Police Forces,Shijiazhuang 050081,China;Affiliated Hospital of Xinjiang Production and Construction Corps of Chinese People's Armed Police Forces,Urumqi 830063,China)

机构地区：[1]新疆医科大学第六附属医院,乌鲁木齐830002 [2]武警河北总队医院 [3]武警兵团总队医院

出　　处：《中国中医骨伤科杂志》2024年第2期32-37,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202024)。

摘　　要：目的:比较三维(3D)打印截骨导板技术与传统全膝关节置换术后下肢本体感觉及平衡功能的差异。方法:50例因重度骨关节炎拟行初次单侧全膝关节置换的患者,用随机数字法分为3D打印截骨导板组和传统手术组,每组各25例。术前两组患者年龄、性别、体重指数、畸形程度差异均无统计学意义(P>0.05)。比较两组患者术后冠状面髋-膝-踝角(HKA)偏差值、冠状面股骨假体组件角偏差值、冠状面胫骨假体组件角偏差值、股骨后髁角(PCA)、髌骨横轴-股骨通髁线角(PFA);比较两组术后3个月美国膝关节协会评分(KSS)临床评分、KSS功能评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分和膝关节活动度;用P-K252平衡仪评估患者本体感觉及平衡能力差异。结果:两组病例均未出现严重并发症。3D打印截骨导板组冠状面股骨假体偏差值、股骨后髁角及PFA小于传统手术组,差异有统计学意义(P<0.05);3D打印截骨导板组KSS功能评分优于传统手术组,差异有统计学意义(P<0.05);3D打印截骨导板组运动轨迹面积、运动轨迹周长小于传统手术组,差异有统计学意义(P<0.05);Berg Balance Scale(BBS)评分大于传统手术组,差异有统计学意义(P<0.05)。两组患者髋-膝-踝角偏差值、冠状面胫骨假体偏差值差异无统计学意义(P>0.05);两组患者KSS临床评分、WOMAC评分、膝关节活动度和平均摆动数值差异无统计学意义(P>0.05)。结论:全膝关节置换术应用3D打印截骨导板能够获得更好的下肢稳定性。Objective:To evaluate the proprioception and balance function of total knee arthroplasty between 3Dprinting personalized osteotomy guide technology and conventional instrumentation.Methods:50patients with primary unilateral total knee arthroplasty were randomly divided into 3Dprinting personalized osteotomy guide technology group and conventional instrumentation group,25patients in each group.There was no statistically significant difference in age,gender,body mass index,and degree of deformity between the two groups preoperative.The hip-knee-ankle angle(HKA),coronal femoral component component angle deviation,coronal tibial component component angle deviation,posterior femoral condyle(PCA)and transverse axis of patella to femoral condyle line angle(PFA)were compared between the two groups.The knee society scores(KSS)clinical score,KSS functional score,Western Ontario and McMaster Universities(WOMAC)score,and knee joint range of motion were compared between the two groups at 3months after surgery.P-K252balancing apparatus was used to evaluate the difference in proprioception and stability of patients.Results:There were no serious complications in both groups.The coronal femoral prosthesis deviation,PCA and PFA in the 3Dprinted osteotomy guide group were less than those in conventional instrumentation group(P<0.05).The KSS functional score of the 3Dprinted osteotomy guide plate group was better than conventional instrumentation group(P<0.05).The motion track area and motion track perimeter of the 3Dprinted osteotomy guide plate group were smaller than conventional instrumentation group(P<0.05),and the Berg Balance Scale(BBS)score was higher than that of conventional instrumentation group(P<0.05).There were no significant difference in HKA deviation and coronal plane tibial prosthesis deviation between the two groups(P<0.05).There were no significant differences in KSS clinical score,WOMAC score,knee joint range of motion and average swing value and knee motion between the two groups(P>0.05).Conclusion:The applicat

关 键 词：全膝关节置换术 三维打印 截骨导板 传统方法 本体感觉 平衡能力 

分 类 号：R687.4[医药卫生—骨科学]