3D打印个体化膝关节置换截骨导向板设计及应用

发布时间：2018-06-14 23:52

本文选题：膝关节置换 + 3D打印技术　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:利用正、逆向工程和3D打印技术设计膝关节置换截骨导向板,并进行初步的临床应用研究。方法:选择20例拟行全膝关节置换术的患者,随机分为两组,两组各10例,3D打印截骨导向板组术前进行骨盆到踝关节最低点的双螺旋CT薄层扫描,利用计算机软件重建患者骨骼模型,分析并计算截骨角度及截骨方向,从而设计截骨定位导航模板,制定手术方案及模拟手术操作。术中按照预先通过数字骨科技术设计的截骨角度进行截骨并置入膝关节假体。传统机械定位手术组采用髓内定位法进行。术后通过CT扫描及三维重建分析比较两组手术的准确性。统计术后2周膝关节HSS评分、膝关节活动度、下肢力线角度等指标来分析比较两组手术的精准性。结果:3D打印截骨导向板组术后2周HSS膝评分为(87.0±2.7)分,膝关节活动度102.3°±3.3°,下肢力线角度(股骨与胫骨机械轴的夹角)为(2.0°±0.4°)。传统机械定位手术组术后2周HSS膝评分为(86.3±2.6)分,膝关节活动度101.6°±4.2°,下肢力线角度(股骨与胫骨机械轴的夹角)为(2.5°±0.5°)。3D打印截骨导向板组与传统机械定位手术组患者的术后2周膝关节HSS评分、膝关节活动度比较差异均无统计学意义(P0.05),而两者之间下肢力线角度比较差异有统计学意义(P0.05)。结论:3D打印技术能够使骨科医生在术前直观地了解膝关节的情况,精确指导制定手术方案,模拟手术操作,提高了手术的精准性。
[Abstract]:Objective: to design the osteotomy guide plate for knee arthroplasty by orthoengineering, reverse engineering and 3D printing, and to carry out a preliminary clinical application study. Methods: twenty patients with total knee arthroplasty were randomly divided into two groups: 10 patients in each group underwent double helical CT scanning from pelvis to the lowest point of ankle joint before operation in each group. The bone model of patients was reconstructed by computer software. The angle and direction of osteotomy were analyzed and calculated. Osteotomy was performed according to the angle of osteotomy designed by digital orthopedic technique and knee prosthesis was implanted. The traditional mechanical localization group was performed by intramedullary localization. The accuracy of operation was compared by CT scan and three-dimensional reconstruction. To compare the accuracy of the two groups, HSS score, knee motion and lower extremity force line angle were analyzed and compared 2 weeks after operation. Results the knee score was 87.0 卤2.7 in the 2 weeks after operation, the range of knee motion was 102.3 掳卤3.3 掳, and the angle of force line of lower extremity (the angle between femur and tibial mechanical axis) was 2.0 掳卤0.4 掳. In the traditional mechanical positioning group, the score of HSS knee was 86.3 卤2.6 at 2 weeks after operation. The range of motion of knee joint was 101.6 掳卤4.2 掳, and the angle of force line of lower extremity (the angle between femur and tibia mechanical axis) was 2.5 掳卤0.5 掳路3D printed osteotomy guide plate group and traditional mechanical positioning group. The score of knee joint HSS was 2 weeks after operation. There was no significant difference in the range of knee motion between the two groups (P 0.05), but there was a significant difference in the angle of the lower limb force line between the two groups (P 0.05). Conclusion the technique of 3 D printing can make orthopedic doctors know the knee joint situation intuitively before operation, guide the operation plan accurately, simulate the operation, and improve the accuracy of the operation.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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