数字化精准全膝关节置换与传统置换方法的短期效果对比  

Comparison of short-term therapeutic effects between digital precision total knee arthroplasty and traditional methods

作　　者：王宇宁 朱浩天 刘康[1] 丁焕文[1,2] 严瀚 Wang Yuning;Zhu Haotian;Liu Kang;Ding Huanwen;Yan Han(South China University of Technology,Guangzhou 510006,Guangdong Province,China;Guangzhou First People's Hospital,Guangzhou 510180,Guangdong Province,China)

机构地区：[1]华南理工大学,广东省广州市510006 [2]广州市第一人民医院,广东省广州市510180

出　　处：《中国组织工程研究》2025年第21期4521-4528,共8页Chinese Journal of Tissue Engineering Research

基　　金：广东省基础与应用基础研究基金项目(2021A1515012564,2023A1515010557),项目负责人:丁焕文;广东省省级科技计划项目(2017B090911008),项目参与人:丁焕文;广东省科学技术厅科技计划基金(2023A03j0957),项目负责人:严瀚;广东省广州市卫生健康委员会重点项目(2023C-TS20),项目负责人:严瀚。

摘　　要：背景:传统全膝关节置换手术在术前的准备有限,作者提出基于计算机仿真和3D打印技术的数字化精准全膝置换方法,旨在通过充分的术前设计来提升置换效果。目的:利用计算机仿真和个性化手术导板建立数字化精准全膝关节置换方法,比较新方法和传统方法的临床效果。方法:回顾性分析97例全膝关节置换患者的临床资料,根据手术方法将患者分为2组,对照组(n=48)采取传统方式进行全膝关节置换手术,使用传统胶片模板;观察组(n=49)采用数字化精准全膝置换方法进行手术,使用计算机辅助技术选定假体尺寸型号。比较两组患者的手术时间、术中出血量、术前及术后美国特种外科医院膝关节评分以及股骨力线和膝关节面线夹角和胫骨角、髋膝踝角与标准角度的差值。结果与结论:(1)两组患者术前性别、年龄、体质量指数、美国特种外科医院膝关节评分,以及胫骨角、股骨力线和膝关节面线夹角、髋膝踝角与标准角度的差值相比差异均无显著性意义(P> 0.05);(2)与对照组比较,观察组手术时间缩短、出血量减少;两组术后3个月膝关节美国特种外科医院膝关节评分对比术前均显著升高(P> 0.05),且术后3个月观察组评分高于对照组(P> 0.05);(3)两组之间胫骨角、股骨力线和膝关节面线夹角、髋膝踝角与标准角度的差值相比差异均有显著性意义,观察组优于对照组(P <0.05);(4)观察组股骨假体预测准确率为94%,对照组为58%;胫骨假体预测准确率为96%,对照组为62%;(5)提示数字化精准全膝关节置换相较传统全膝关节置换的手术时间更短、出血量更少、术后膝关节功能评分和力线恢复更好,具有良好的短期临床效果。BACKGROUND:Traditional total knee arthroplasty has limited preoperative preparation.We propose a digital precision total knee arthroplasty based on computer simulation and 3D printing technology,aiming to enhance surgical outcomes through comprehensive preoperative planning.OBJECTIVE:To establish a digital precision total knee arthroplasty using computer simulation and personalized surgical guides,and to compare the clinical outcomes between the new and traditional approaches.METHODS:A retrospective analysis was conducted on 97 patients who underwent total knee arthroplasty.Patients were divided into two groups based on the surgical method they received.The control group(n=48)underwent total knee arthroplasty using traditional methods and used conventional film templates.The observation group(n=49)underwent surgery using the digital precision total knee arthroplasty and utilized computer-assisted technology to select prosthetic sizes.Surgical time,intraoperative blood loss,preoperative and postoperative Hospital for Special Surgery knee joint function scores,as well as the differences in femoral alignment,knee joint line angle and tibial slope,and hip-knee-ankle angle compared to standard angles were compared between the two groups.RESULTS AND CONCLUSION:(1)There were no significant differences in gender,age,body mass index,Hospital for Special Surgery knee scores,as well as the differences in tibial slope,femoral alignment,knee joint line angle,hip-knee-ankle angle compared to standard angles between the two groups(P>0.05).(2)Compared to the control group,the observation group showed shorter surgical time,reduced blood loss,and significant increases in knee joint Hospital for Special Surgery knee scores at 3 months postoperatively compared to preoperative scores(P>0.05).Additionally,the postoperative Hospital for Special Surgery knee scores were higher in the observation group than in the control group(P>0.05).(3)The differences in tibial slope,femoral alignment,knee joint line angle,and hip-knee-ankle angle com

关 键 词：3D打印 全膝关节置换 个性化截骨导板 假体预测 计算机仿真 下肢力线 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R68