3D打印模型术前规划辅助THA重建发育性髋关节发育不良患者髋臼的临床研究  

Clinical Study of 3D Printing Solid Model Assisted Preoperative Planning in Total Hip Arthroplasty for Acetabular Reconstruction in Patients with Developmental Dysplasia of the Hip

作　　者：吴龙[1] 刘莉 赵鑫 李鹏[1] 陆志东[1] WU Long;LIU Li;ZHAO Xin;LI Peng;LU Zhidong(Department of Orthopedics,General Hospital of Ningxia Medical University,First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;Department of Ningxia Medical 3D Printing Engineering Technology Research Center,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院骨三科,宁夏医科大学第一临床医学院,银川750004 [2]宁夏医学3D打印工程技术研究中心,银川750004

出　　处：《宁夏医科大学学报》2025年第1期47-52,共6页Journal of Ningxia Medical University

基　　金：宁夏医科大学校级教育教学改革研究项目(NYJY 2024037);宁夏回族自治区重点研发计划项目(2021BEG02037)。

摘　　要：目的 分析在3D打印模型术前规划辅助下完成全髋关节置换(THA)重建发育性髋关节发育不良(DDH)患者髋臼的有效性与安全性。方法 回顾性收集接受单侧、初次THA手术治疗的73例DDH患者病历资料,3D打印组(34例)通过3D打印技术制作实体模型术前规划辅助制定个体化的手术方案;传统置换组(39例)按照常规手术流程完成手术。记录并比较两组的手术时间、术中出血量、术前规划髋臼假体型号的准确率、术后髋臼假体的外展角、前倾角、位于Lewinnek安全区的比例、髋臼假体旋转中心与健侧旋转中心距同侧泪滴的水平距离和垂直距离的差值及围术期并发症。结果 3D打印组手术时间和术中出血量较传统置换组均减少(P均<0.05);3D打印组预测髋臼假体型号的准确率高于传统置换组(P<0.05);3D打印组术后髋臼假体的外展角、前倾角更大,在Lewinnek安全区内的比例更高(P均<0.05);3D打印组髋臼旋转中心与健侧旋转中心的水平距离与垂直距离偏差更小,旋转中心更接近正常位置(P均<0.05);随访期间两组患者均无手术并发症发生。结论 3D打印模型术前规划辅助THA治疗DDH安全、有效、更佳精准,早期临床疗效良好。Objective To assess the effectiveness and safety of three-dimensional(3D)printing solid model-assisted preoperative planning in total hip arthroplasty for acetabular reconstruction in patients with developmental dysplasia of the hip.Methods Clinical data of 73 patients with developmental dysplasia of the hip(DDH),who underwent primary unilateral THA in Department of Orthopedics,General Hospital of Ningxia Medical University,were retrospectively collected.The 34 patients in 3D printing group underwent total hip arthroplasty with the aid of 3D printing solid model-assisted preoperative planning,and 39 patients in the traditional operation group underwent traditional total hip arthroplasty. Perioperative information was recorded and analyzed,such as the operation time,intraoperative blood loss,the accuracy of preoperative planning of acetabular prosthesis size,the postoperative inclination angle and the anteversion angle of the acetabular cup,the rate of acetabular cup within the Lewinnek“safe zone”,the horizontal and vertical difference of acetabular rotation center between the affected and the normal side,and occurrence of complication. Results The operation time and intraoperative blood loss in 3D printing group were significantly less than those in traditional group(P all<0.05). The accuracy of preoperative planning of acetabular prosthesis size in 3D printing group was significantly higher than that in traditional group(P<0.05). Postoperative inclination angle and anteversion angle of the acetabular cup and the rate of acetabular cup within the Lewinnek“safe zone”were higher in 3D printing group(P all<0.05). The horizontal and vertical difference of acetabular rotation center between the affected and the normal side in 3D printing group were significanly smaller(P all<0.05),the rotation center was closer to its normal position. During the follow-up period,neither group of patients experienced any surgical complications. Conclusion 3D printing solid model-assisted preoperative planning in total hip arthr

关 键 词：3D打印技术 全髋关节置换 发育性髋关节发育不良 假体型号 髋臼旋转中心 

分 类 号：R687.4[医药卫生—骨科学]