3D打印体外导板辅助髋关节镜治疗凸轮型股骨髋臼撞击综合征的前瞻性研究  

Prospective study of three-dimensional-printed in vitro guide plates assisted hip arthroscopy in treatment of Cam-type femoroacetabular impingement

作　　者：杨东强 魏松松[3] 刘一军 胡勇 YANG Dongqiang;WEI Songsong;LIU Yijun;HU Yong(Department of Orthopedics,the First Affiliated Hospital of Anhui Medical University,Hefei Anhui,230032,P.R.China;Department of Orthopedics,Fuyang People’s Hospital,Fuyang Anhui,236000,P.R.China;Department of Orthopedics,the Second People’s Hospital of Fuyang,Fuyang Anhui,236000,P.R.China)

机构地区：[1]安徽医科大学第一附属医院骨科,合肥230032 [2]阜阳市人民医院骨科,安徽阜阳236000 [3]阜阳市第二人民医院骨科,安徽阜阳236000

出　　处：《中国修复重建外科杂志》2024年第12期1474-1479,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：安徽省高校自然科学基金重大项目(KJ2020ZD17);阜阳市科技局立项课题项目(FK202081025)。

摘　　要：目的采用前瞻性研究,探讨3D打印体外导板辅助髋关节镜治疗凸轮型股骨髋臼撞击综合征(femoroacetabular impingement,FAI)的可行性及有效性。方法收集2016年12月—2022年9月符合选择标准的25例凸轮型FAI患者临床资料。男13例,女12例;年龄19~66岁,平均42岁。自然病程3~120个月,平均22.2个月。术前内旋-外旋活动度为(28.70±4.50)°,α角为(69.04±0.99)°,疼痛视觉模拟评分(VAS)为(6.5±0.2)分,改良Harris髋关节功能评分(HHS)为(50.5±0.7)分。均采用3D打印体外导板辅助髋关节镜治疗。术后观察并发症发生情况,患者均完善手术前后影像学检查,Dunn位X线片上测量患侧髋关节α角,MRI观察有无盂唇损伤;行三维CT+重建检查计算凸轮成形范围与术前模拟打磨区域重合的百分比。采用VAS评分、改良HHS评分评价临床疗效。结果术后1例患者出现足背麻木,给予营养神经等常规药物治疗,1个月后症状消失;2例出现会阴区皮肤损伤,对症处理后自愈。无男性勃起功能障碍以及切口深部感染、肺栓塞等严重并发症发生。患者术后凸轮成形范围与术前模拟打磨区域重合的百分比为81.6%~95.3%,平均89.8%。25例患者均获随访,随访时间6~12个月,平均8个月。末次随访时,内旋-外旋活动度为(40.10±2.98)°,α角为(43.72±0.84)°,VAS评分为(1.8±0.2)分,改良HHS评分为(72.1±1.3)分,均较术前显著改善,差异有统计学意义(P<0.05)。结论3D打印体外导板辅助髋关节镜治疗凸轮型FAI安全、可行,可取得良好临床疗效。Objective A prospective study was conducted to investigate the feasibility and effectiveness of threedimensional printed in vitro guide plates assisted hip arthroscopy in the treatment of Cam-type femoroacetabular impingement(FAI).Methods The clinical data of 25 patients with Cam-type FAI who met the selection criteria between December 2016 and September 2022 were collected.There were 13 males and 12 females with an average age of 42 years(range,19-66 years).The disease duration ranged from 3 to 120 months,with an average of 22.2 months.The preoperative range of internal rotation-external rotation was(28.70±4.50)°,αangle was(69.04±0.99)°,visual analogue scale(VAS)score was 6.5±0.2,and modified Harris hip score(HHS)was 50.5±0.7.All patients were treated with hip arthroscopy assisted by three-dimensional printed in vitro guide plate.The occurrence of complications was observed postoperatively,αangle of the affected hip joint was measured on Dunn X-ray film,and the glenoid labrum injury was observed by MRI.The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was calculated by threedimensional CT+reconstruction.The effectiveness was evaluated by VAS score and modified HHS score.Results Postoperative dorsalis pedis numbness occurred in 1 case,and the symptoms disappeared after 1 month of conventional drug treatment such as neurotrophy.Two cases of perineal skin injury occurred,and healed after symptomatic treatment.There was no male erectile dysfunction,deep incision infection,pulmonary embolism,or other serious complications occurred.The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was 81.6%-95.3%,with an average of 89.8%.All 25 patients were followed up 6-12 months,with an average of 8 months.At last follow-up,the range of internal rotation-external rotation was(40.10±2.98)°,αangle was(43.72±0.84)°,VAS score was 1.8±0.2,and the modified HHS score was 72.1±1.3,which significantly improved when compared with

关 键 词：3D打印技术 髋关节镜 股骨髋臼撞击综合征 前瞻性研究 

分 类 号：R687.4[医药卫生—骨科学]