3D打印截骨模板辅助膝关节精准手术的应用研究

发布时间：2018-02-27 18:39

本文关键词： 全膝关节置换个性化截骨模板下肢力线髋-膝-踝角　出处：《贵州医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:1、探讨个性化截骨导航模板辅助膝关节置换手术与传统置换手术的临床疗效;2、寻找一种标准化、适宜推广普及的TKA手术方式。方法:选择贵州省骨科医院2015年6月一2016年12月行全膝关节置换术(TKA)21例21膝重度骨性关节炎患者,采用定制3D个性化截骨模板辅助TKA(3D组),同期随机选择22例22膝患者采用传统手术方式行TKA(传统组)。两组患者的年龄、性别、术前站立负重位影像学(X线)冠状位股骨和胫骨机械轴的夹角(髋-膝-踝角)、术前HSS评分上无统计学意义;记录两组患者手术时间、显性出血量(术中出血量+术后伤口引流量)、术后髋-膝·踝角、术后胫骨后倾角和术后3月HSS评分。结果:显性出血量3D组为(259.5±40.4)ml,传统组(396.8±50.8)ml,差异比较具有统计学意义(P0.05);术后下肢力线髋-膝-踝角3D组为(1.01±0.33)°,传统组为(2.32±0.47)°,术后胫骨后倾角 3D 组为(2.93±0.08)°,传统组为(4.02±0.41)°,差异均具有统计学意义(P0.05);术后3月HSS评分3D组为(92.7±0.2),传统组为(91.0±0.5),两组差异比较具有统计学意义(P0.05)。结论:3D打印个性化截骨导航模板辅助TKA手术操作简便,具有能提高下肢力线的精确性,缩短手术时间,减少出血、良好功能等优势,适宜推广普及。
[Abstract]:Objective: to explore the clinical effect of individualized osteotomy and navigation template for knee arthroplasty and to find out a kind of standardization. Methods: 21 cases of 21 patients with severe osteoarthritis of knee were treated with total knee arthroplasty in Guizhou Orthopaedic Hospital on June 1st 2015 and December 2016. A customized 3D osteotomy template was used to assist the TKA(3D group. 22 patients with 22 knees were randomly selected to perform TKA with traditional surgical methods at the same time. The age and sex of the patients in the two groups were compared. The angle of the mechanical axis of femur and tibia in coronal position (hip knee ankle angle) had no statistical significance in preoperative HSS score. Dominant bleeding volume (intraoperative bleeding volume, postoperative wound drainage volume, postoperative hip, knee and ankle angle, Postoperative tibial posterior inclination and HSS score on March. Results: the dominant bleeding volume was 259.5 卤40.4ml in 3D group, 396.8 卤50.8ml in traditional group, the difference was statistically significant (P 0.05), the force line of lower extremity was 1.01 卤0.33 掳in 3D group, 2.32 卤0.47 掳in traditional group, and 2.32 卤0.47 掳in traditional group. The obliquity of 3D group was 2.93 卤0.08 掳, and that of traditional group was 4.02 卤0.41 掳, the difference was statistically significant (P 0.05), the HSS score of 3D group was 92.7 卤0.2% on March, and that of traditional group was 91.0 卤0.5 掳. The difference between the two groups was statistically significant (P 0.05). It has the advantages of improving the accuracy of the force line of the lower limb, shortening the operation time, reducing the bleeding, good function and so on, so it is suitable for popularization.
【学位授予单位】：贵州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

【参考文献】