3D打印定制假体及其在髋关节翻修髋臼重建应用中的研究进展  

Research progress of three-dimensional printed customized prosthesis and its application in acetabular reconstruction of hip revision surgery

作　　者：张衡 马晓东 李博闻 李宽新 刘扬 周建生 陶钧 ZHANG Heng;MA Xiaodong;Li Bowen;LI Kuanxin;LIU Yang;ZHOU Jiansheng;TAO Jun(Department of Orthopedics,the First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui,233004,P.R.China;Laboratory of Tissue and Transplant in Anhui Province,Bengbu Medical University,Bengbu Anhui,233004,P.R.China;Department of Orthopedics,the First Affiliated Hospital of Anhui University of Science&Technology,Huainan Anhui,232000,P.R.China)

机构地区：[1]蚌埠医科大学第一附属医院骨科,安徽蚌埠233004 [2]蚌埠医科大学组织移植安徽省重点实验室,安徽蚌埠233004 [3]安徽理工大学第一附属医院骨科,安徽淮南232000

出　　处：《中国修复重建外科杂志》2024年第11期1414-1420,共7页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：蚌埠医学院第一附属医院优秀青年科学基金项目(2021byyfyyq04)。

摘　　要：目的总结3D打印定制假体设计制造、性能及其在髋关节翻修髋臼重建应用中的研究进展。方法在中国知网、万方数据库、PubMed等中、英文数据库以“3D打印定制假体”、“髋关节翻修”、“髋臼骨缺损”、“髋臼重建”以及“3D printed customized prosthesis”、“revision hip arthroplasty”、“acetabular bone defect”、“acetabular reconstruction”为关键词,检索2013年1月—2024年5月有关3D打印定制假体及其在髋关节翻修髋臼重建应用的相关文献34271篇,经阅读文献题目、摘要或全文,筛除不符合内容、重复、质量较低、证据等级不高的文献,最终纳入文献共48篇,对其进行分析、总结。结果3D打印定制假体的骨长入、力学性能优于非3D打印定制假体,进一步解决了“应力屏蔽”导致的植入物与天然骨之间弹性模量不匹配的问题;其多孔结构和表面抗菌涂层有良好的抑菌作用;可以完全匹配患者个体化髋臼解剖特点和缺损类型,从而提高髋臼重建的精准性并减少手术时间和创伤。结论3D打印定制假体可以精准、高效地实现髋关节翻修髋臼个体化重建,获得良好的早中期临床疗效;但是有待进一步优化生产工艺和流程,以提高临床应用的效率和远期疗效。Objective To review research progress on the design,manufacturing,and clinical application of three-dimensional(3D)printed customized prosthesis in acetabular reconstruction of hip revision surgery.Methods The related research literature on 3D printed customized prosthesis and its application in acetabular reconstruction of hip revision surgery was searched by key words of“3D printed customized prosthesis”,“revision hip arthroplasty”,“acetabular bone defect”,and“acetabular reconstruction”between January 2013 and May 2024 in Chinese and English databases,such as CNKI,Wanfang database,PubMed,etc.A total of 34271 articles were included.After reading the literature titles,abstracts,or full texts,the literature of unrelated,repetitive,low-quality,and low evidence level was screened out,and a total of 48 articles were finally included for analysis and summary.Results The bone growth and mechanical properties of 3D printed customized prosthesis materials are better than those of non-3D printed customized prosthesis,which further solves the problem of elastic modulus mismatch between the implant and natural bone caused by“stress shielding”;the porous structure and antibacterial coating on the surface of 3D printed customized prosthesis have good anti-bacterial effect.3D printed customized prosthesis can perfectly match the patient’s individual acetabular anatomical characteristics and defect type,thus improving the accuracy of acetabular reconstruction and reducing the surgical time and trauma.Conclusion 3D printed customized prosthesis can be used for precise and efficient individualized acetabular reconstruction in hip revision surgery with good early-and mid-term effectiveness.More optimized production technics and procedures need to be developed to improve the efficiency of clinical application and long-term effectiveness.

关 键 词：髋关节翻修 髋臼骨缺损 髋臼重建 3D打印定制假体 

分 类 号：R687.4[医药卫生—骨科学]