3D打印联合Jumbo杯在髋关节翻修术中的临床应用效果研究  

Study on clinical effect of 3D printing combined with Jumbo cup in revision hip arthroplasty

作　　者：付睿军 姬广林 朱文清 黄金澎 何澄 杨德胜 FU Rui-jun;JI Guang-lin;ZHU Wen-qing(Department of Orthopaedics,The First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China)

机构地区：[1]赣南医科大学第一附属医院骨科,341000 [2]于都县人民医院关节外科,341000

出　　处：《中国实用医药》2025年第3期19-24,共6页China Practical Medicine

基　　金：江西省卫生健康委科技计划(项目编号:SKJP220228306)。

摘　　要：目的探讨术前3D打印联合Jumbo杯用于髋关节翻修术中的临床疗效。方法回顾性分析采用3D打印联合Jumbo杯治疗的22例(23髋)髋关节置换术后假体松动(全关节松动或髋臼侧假体松动)伴髋臼侧骨缺损行髋关节翻修术患者的临床资料。观察患者髋关节功能及疼痛情况,影像学改变情况。结果22例患者均得到了随访,平均随访时间(4.0±1.7)个月。末次随访时Harris评分(87.9±5.3)分高于术前的(32.7±12.1)分,差异有统计学意义(P<0.05)。末次随访时视觉模拟评分法(VAS)评分(0.61±0.49)分低于术前的(7.56±0.99)分,差异有统计学意义(P<0.05)。①患侧髋关节中心水平距离术前平均(3.05±0.61)cm,术后平均(3.44±0.47)cm,对侧(健侧)平均(3.55±0.43)cm。术后大于术前,差异有统计学意义(P<0.05)。术后与对侧(健侧)对比,差异无统计学意义(P>0.05)。②患侧髋关节中心垂直距离术前平均(3.09±0.67)cm,术后平均(2.65±0.62)cm,对侧(健侧)平均(2.27±0.64)cm。术后小于术前,差异有统计学意义(P<0.05)。术后大于对侧(健侧),差异有统计学意义(P<0.05)。③患侧股骨偏心距术前平均(4.07±0.38)cm,术后平均(4.45±0.28)cm,对侧(健侧)平均(4.45±0.27)cm。术后大于术前,差异有统计学意义(P<0.05)。术后与对侧(健侧)对比,差异无统计学意义(P>0.05)。末次随访的髋臼旋转中心位置与术前相比得到明显改变,与健侧相比虽然仍稍处于高位,但基本重建了正常的髋臼旋转中心。所有患者末次随访时假体与骨接触紧密,缺损区被完全填充,植骨整合替代满意,所有患者均无≥2 mm的明显透亮线,没有发现螺钉断裂、假体移位脱位等情况。结论对于存在髋臼骨缺损行髋关节翻修术的患者,术前完善患侧髋关节3D打印模型,可以准确直观地根据其髋臼缺损情况,按照Paprosky进行分型,PaproskyⅠ、Ⅱ、ⅢA型患者均可使用Jumbo杯进行关节翻修,Jumbo杯的使用可为髋臼假体�Objective To explore the clinical efficacy of preoperative 3D printing combined with Jumbo cup in revision hip arthroplasty.Methods A retrospective analysis was conducted on clinical data of 22 patients(involving 23 hips)who underwent revision hip arthroplasty due to prosthesis loosening(total joint or acetabular prosthesis loosening)accompanied by acetabular bone defects.Hip function and pain,and imaging changes of patients were observed.Results All 22 patients were followed up,with an average follow-up time of(4.0±1.7)months.The Harris score of(87.9±5.3)points at the last follow-up was higher than(32.7±12.1)points before surgery,and the difference was statistically significant(P<0.05).The visual analogue scale(VAS)score of(0.61±0.49)points at the last follow-up was lower than(7.56±0.99)points before surgery,and the difference was statistically significant(P<0.05).(i)The horizontal distances of hip joint center was(3.05±0.61)cm before surgery and(3.44±0.47)cm after surgery on the affected side,and(3.55±0.43)cm on the contralateral healthy side;the horizontal distances of hip joint center on the affected side after surgery was greater than that before surgery,and the difference was statistically significant(P<0.05);comparing the horizontal distances of hip joint center on the affected side after surgery with the contralateral healthy side,the difference was not statistically significant(P>0.05).(ii)The vertical distances of hip joint center was(3.09±0.67)cm before surgery and(2.65±0.62)cm after surgery on the affected side,and(2.27±0.64)cm on the contralateral healthy side;the horizontal distances of hip joint center on the affected side after surgery was smaller than that before surgery,and the difference was statistically significant(P<0.05);the horizontal distances of hip joint center on the affected side after surgery was greater than that on the contralateral healthy side,and the difference was statistically significant(P<0.05).(iii)The femoral offset was(4.07±0.38)cm before surgery and(4.45±0.2

关 键 词：Jumbo杯 3D打印 髋关节翻修术 髋关节旋转中心 

分 类 号：R687.4[医药卫生—骨科学]