3D打印技术辅助人工全膝关节置换术治疗合并关节外畸形的膝骨关节炎
发布时间：2018-11-01 19:32
【摘要】：目的探讨3D打印技术辅助人工全膝关节置换术(total knee arthroplasty,TKA)治疗合并关节外畸形的膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法 2013年3月—2015年12月,收治15例(18膝)合并关节外畸形的KOA患者。男6例(6膝),女9例(12膝);年龄55~70岁,平均60.2岁;病程7~15年,平均10.8年。单膝12例,双膝3例。膝关节学会评分系统(KSS)临床评分为(57.44±1.06)分,功能评分为(60.88±1.26)分。膝关节活动度为(72.22±0.18)°。下肢力线偏移(18.89±0.92)°。合并股骨侧畸形8例(10膝),胫骨侧畸形5例(5膝),股骨侧及胫骨侧畸形2例(3膝)。术前3D打印骨骼模型、截骨导航模板并设计手术方案,选择合适的膝关节假体后实施TKA。结果手术时间65~100 min,平均75.6 min;术中出血量50~150 m L,平均90.2 m L。术后均未出现切口愈合不良、感染、血栓等并发症。患者均获随访,随访时间12~30个月,平均22个月。末次随访时,X线片示假体位置均良好,未发现松动、下沉;下肢力线偏移(2.00±0.29)°,与术前比较差异有统计学意义(t=13.120,P=0.007);KSS临床评分为(87.50±0.88)分、功能评分为(81.94±1.41)分,与术前比较差异有统计学意义(t=27.553,P=0.000;t=35.551,P=0.000);膝关节活动度为(101.94±1.42)°,与术前比较差异有统计学意义(t=31.633,P=0.000)。结论对于合并关节外畸形的KOA,采用3D打印技术辅助TKA,可达到个体化治疗、降低手术难度,有效矫正畸形,恢复患者膝关节功能的目的。
[Abstract]:Objective to investigate the clinical effect of 3 D printing assisted total knee arthroplasty (total knee arthroplasty,TKA) in the treatment of knee osteoarthritis (knee osteoarthritis,KOA) with extraarticular deformity. Methods from March 2013 to December 2015, 15 KOA patients (18 knees) with extraarticular malformation were treated. Male 6 cases (6 knees), female 9 cases (12 knees), age 5570 years, mean 60.2 years, course of disease 7 ~ 15 years, mean 10.8 years. There were 12 cases with single knee and 3 cases with double knee. The (KSS) clinical score and the functional score were (57.44 卤1.06) and (60.88 卤1.26) respectively. The range of knee motion was (72.22 卤0.18) 掳. The lower limb force line deviation was (18.89 卤0.92) 掳. 8 cases (10 knees) were associated with femoral side malformation, 5 cases (5 knees) were tibial side deformities, 2 cases (3 knees) were femoral and tibial side deformities. Preoperative 3D printing of bone model, osteotomy navigation template and design of surgical procedures, selection of appropriate knee prosthesis after the implementation of TKA. Results the operative time was 65 ~ 100 min, and the average blood loss was 75. 6 min;. The average blood loss was 90. 2 mL. There were no complications such as poor wound healing, infection, thrombus and so on. All patients were followed up for 12 ~ 30 months (mean 22 months). At the last follow-up, the position of the prosthesis was good, no loosening and sinking were found, the force line deviation of lower extremity was (2.00 卤0.29) 掳, which was significantly different from that before operation (t _ (13.120) P _ (0.007). The clinical score of KSS was (87.50 卤0.88), and the score of function was (81.94 卤1.41), which was significantly different from that before operation (t = 27.553). The range of motion of knee joint was (101.94 卤1.42) 掳, which was significantly different from that before operation (t = 31.633P = 0.000). Conclusion for KOA, with extraarticular malformation, 3D printing technique can be used to assist TKA, to achieve individualized treatment, to reduce the difficulty of operation, to correct deformity effectively and to recover the function of knee joint.
【作者单位】： 福建中医药大学附属泉州市正骨医院关节外科;厦门大学附属福州市第二医院关节外科;
【分类号】：R687.4
[Abstract]:Objective to investigate the clinical effect of 3 D printing assisted total knee arthroplasty (total knee arthroplasty,TKA) in the treatment of knee osteoarthritis (knee osteoarthritis,KOA) with extraarticular deformity. Methods from March 2013 to December 2015, 15 KOA patients (18 knees) with extraarticular malformation were treated. Male 6 cases (6 knees), female 9 cases (12 knees), age 5570 years, mean 60.2 years, course of disease 7 ~ 15 years, mean 10.8 years. There were 12 cases with single knee and 3 cases with double knee. The (KSS) clinical score and the functional score were (57.44 卤1.06) and (60.88 卤1.26) respectively. The range of knee motion was (72.22 卤0.18) 掳. The lower limb force line deviation was (18.89 卤0.92) 掳. 8 cases (10 knees) were associated with femoral side malformation, 5 cases (5 knees) were tibial side deformities, 2 cases (3 knees) were femoral and tibial side deformities. Preoperative 3D printing of bone model, osteotomy navigation template and design of surgical procedures, selection of appropriate knee prosthesis after the implementation of TKA. Results the operative time was 65 ~ 100 min, and the average blood loss was 75. 6 min;. The average blood loss was 90. 2 mL. There were no complications such as poor wound healing, infection, thrombus and so on. All patients were followed up for 12 ~ 30 months (mean 22 months). At the last follow-up, the position of the prosthesis was good, no loosening and sinking were found, the force line deviation of lower extremity was (2.00 卤0.29) 掳, which was significantly different from that before operation (t _ (13.120) P _ (0.007). The clinical score of KSS was (87.50 卤0.88), and the score of function was (81.94 卤1.41), which was significantly different from that before operation (t = 27.553). The range of motion of knee joint was (101.94 卤1.42) 掳, which was significantly different from that before operation (t = 31.633P = 0.000). Conclusion for KOA, with extraarticular malformation, 3D printing technique can be used to assist TKA, to achieve individualized treatment, to reduce the difficulty of operation, to correct deformity effectively and to recover the function of knee joint.
【作者单位】： 福建中医药大学附属泉州市正骨医院关节外科;厦门大学附属福州市第二医院关节外科;
【分类号】：R687.4
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