基于3D打印技术行全膝关节置换治疗内翻畸形膝骨性关节炎

发布时间：2018-11-16 15:54

【摘要】：背景:传统全膝关节置换因其复杂的髓内定位技术、过度依赖术者经验截骨而广为诟病,在3D打印技术辅助下行全膝关节置换能够更加精确的进行定位、截骨。目的:比较在3D打印技术辅助下行全膝关节置换治疗膝内翻畸形与传统治疗方案临床疗效的差异。方法:收集接受初次单侧全膝关节置换治疗膝内翻畸形患者的临床资料34例,采用随机数字表法分为2组,每组17例。其中一组患者在3D打印截骨导板辅助下行全膝关节置换治疗(3D打印组);另外一组患者接受传统全膝关节置换治疗(常规组)。记录2组患者出血量(包括术中出血量及术后引流量)、手术时间,关节置换后2周时美国特种外科医院(Hospital for Special Surgery,HSS)膝评分、膝关节活动度及股骨与胫骨机械轴夹角。结果与结论:(1)3D打印组关节置换后2周膝关节活动范围大于常规组,但差异无显著性意义(P=0.744);(2)3D打印组关节置换后2周HSS膝关节评分2组差异无显著性意义(P=0.532);(3)置换后股骨与胫骨机械轴夹角,2组差异无显著性意义(t=0.218,P=0.632);(4)3D打印组手术时间较常规组显著缩短(P=0.000);(5)3D打印组出血量较常规组显著减少(P=0.000);(6)结果表明,应用3D打印截骨导板辅助行全膝关节置换后2周膝关节活动范围、HSS评分及下肢力线恢复情况无显著差异,但具有手术时间短,出血量少,截骨更精确等优点,更适合于高龄、基础状态差、创伤承受能力小,要求迅速完成手术的患者。Su
[Abstract]:Background: traditional total knee arthroplasty is widely criticized for its complex intramedullary localization technology and over-reliance on empirical osteotomy. Objective: to compare the clinical efficacy of total knee arthroplasty (TKR) with 3D printing in the treatment of varus genu deformity. Methods: the clinical data of 34 patients with varus genu deformity were collected and divided into 2 groups with 17 cases in each group. One group received total knee arthroplasty (3D printing group) and the other group received traditional total knee arthroplasty (conventional group). The bleeding volume (including intraoperative bleeding and postoperative drainage), operative time, (Hospital for Special Surgery,HSS score, knee motion and the angle between femur and tibia mechanical axis were recorded in the two groups. Results and conclusion: (1) the range of knee joint motion in 3D printing group was larger than that in routine group 2 weeks after arthroplasty, but there was no significant difference (P < 0. 744). (2) there was no significant difference in HSS knee joint score 2 weeks after arthroplasty in 3D printing group (P0. 532); (3). There was no significant difference in the angle between femur and tibia mechanical axis after arthroplasty (t0. 218 P0. 632). (4) the operative time of 3D printing group was significantly shorter than that of routine group (P0. 000); (5). The amount of bleeding in 3D printing group was significantly lower than that in normal group (P0. 000). (6) the results showed that there was no significant difference in the range of knee motion, the HSS score and the recovery of lower limb force line in 2 weeks after total knee arthroplasty with 3D printed osteotomy plate, but the operation time was short and the amount of bleeding was less. The advantages of osteotomy are more accurate, more suitable for patients with advanced age, poor basic condition, small trauma tolerance, and require the rapid completion of the operation. Su
【作者单位】：中国医科大学附属第四医院骨科;
【分类号】：R687.4;TP391.73

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