3D打印钛合金骨小梁金属臼杯治疗老年初次全髋关节置换术的疗效

发布时间：2018-10-26 18:03

【摘要】：目的探讨3D打印钛合金骨小梁金属臼杯在老年初次全髋关节置换术中的疗效。方法前瞻性选取西藏民族大学医学部临床医学院需行初次全髋关节置换术的老年患者27例,根据受试者个人意愿分为研究组(3D打印钛合金骨小梁金属臼杯)12例和对照组(经典Pinnacle臼杯)15例。分别与术后1 w、3个月、6个月进行门诊随访,进行髋关节功能(Harris)、骨性关节炎(WOMAC)指数,健康调查量表(SF-36)评分;同时进行影像学评估,使用DeLee和Charnley分区法检测髋臼假体位置;Anderson骨长入影像学评价标准对骨长入进行评估。结果术后6个月两组Harris评分、SF-36评分均显著高于术前,WOMAC指数显著低于术前(P0.05);术后6个月研究组Harris评分、SF-36评分显著高于对照组,WOMAC指数显著低于对照组(P0.05)。术后研究组臼杯未出现外展角变化和移位,10例术后1 w 3D打印钛合金骨小梁金属臼杯与骨面接触紧密且无透亮线,2例臼杯植入后1 w时可见透亮线,术后6个月时透亮线消失,随访期间未出现新的透亮带;术后随访期间1区无骨质增生,2区无应力遮挡,两个区均无髋臼表面辐射状排列的骨小梁,4例术后6个月3区出现骨质增强。对照组臼杯与关节面接触紧密,随访期间未出现透亮线,其中4例2区存在应力遮挡,均未出现骨质增强。结论老年初次全髋关节置换术中采用3D打印钛合金骨小梁金属臼杯的稳定性好,早期骨长入优于传统材料,短中期预后效果较佳,但长期效果仍需进一步研究。
[Abstract]:Objective to evaluate the efficacy of 3D printing titanium alloy trabecular metal cup in the primary total hip arthroplasty in the elderly. Methods A prospective selection of 27 elderly patients undergoing initial total hip arthroplasty was performed in the Department of Clinical Medicine, Tibetan University for nationalities. According to their personal wishes, the subjects were divided into study group (3D printed titanium alloy trabecular metal cup) and control group (classical Pinnacle cup). The (WOMAC) index of hip function (Harris), osteoarthritis (Osteoarthritis) and the score of Health Survey scale (SF-36) were evaluated 1 week, 3 months and 6 months after operation respectively. At the same time, the location of acetabular prosthesis was detected by DeLee and Charnley, and the long bone was evaluated by Anderson imaging criteria. Results six months after operation, Harris score, SF-36 score and WOMAC index of the two groups were significantly higher than those before operation (P0.05). Six months after operation, the Harris score, SF-36 score and WOMAC index of the study group were significantly higher than those of the control group (P0.05). In the study group, there was no change and displacement of the abduction angle in the acetabular cup, 10 cases of the titanium alloy bone trabecular metal cup had close contact with the bone surface and there was no clear line at 1 week after the implantation of the acetabular cup in 10 cases, and the transparent line could be seen in 2 cases at 1 week after the implantation of the cup. At 6 months after operation, the transparent line disappeared, and no new light band appeared during the follow-up. There was no hyperosteogeny in area 1, no stress occlusion in area 2, no radial bone trabeculae on acetabular surface in both regions, and bone enhancement occurred in 3 areas in 4 cases 6 months after operation. In the control group, the acetabular cup was in close contact with the articular surface, and there was no clear line during the follow-up. In 4 cases, there was stress occlusion in area 2, and no bone enhancement was found in all cases. Conclusion 3D printed titanium alloy trabecular metal cup has good stability in the primary total hip arthroplasty in the elderly, the early bone growth is better than the traditional material, and the short and medium term prognosis is better, but the long-term effect still needs further study.
【作者单位】：西藏民族大学医学部临床医学院骨科;
【基金】：西藏科技厅科技项目(2016ZR-MY-05)
【分类号】：R687.4

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