3D打印假体技术治疗四肢骨关节肿瘤
发布时间：2018-11-21 20:20
【摘要】：[目的]探讨3D打印四肢关节肿瘤假体在四肢大关节肿瘤手术治疗中的新方法。[方法]2014年1月~2016年5月在本院接受治疗的四肢关节骨肿瘤患者共6例,全部患者术前都对兴趣区域行CT扫描(层厚为1.0mm),获得平面图像信息,再通过三维重建,得到DICOM格式数据,将数据导入Mimics 17.0软件中,编辑三维立体模型,在模型上确定截骨部位,并设计与剩余骨组织匹配的内置物假体,包括钛合金假体的孔径、密度及孔隙度,新的韧带附丽点。随访时利用国际骨骼肌肉肿瘤保肢(MSTS)功能评分系统对患者的预后进行评估。[结果]所有患者都获得随访,随访时间4~25个月,平均13.2个月,术后经X线片证实剩余骨组织与肿瘤型假体匹配良好,未见假体松动及骨溶解,未见肿瘤复发及转移,6例患者仍存活,各关节功能恢复良好,最后一次随访时MSTS得分为17~28分,平均25.7分,其中优3例,良2例,可1例,优良率达83.3%。[结论]通过3D打印技术的应用,可确定精确截骨范围,设计个体化关节假体,调整钛合金假体的孔径、密度及孔隙度,在假体上设计个体化韧带附丽点,使之接近正常生理解剖,术后关节功能良好,为治疗四肢关节骨肿瘤提供了一种新的方法。
[Abstract]:Objective: to explore a new method of 3D printing prosthesis for large joint tumor of extremities. [methods] from January 2014 to May 2016, 6 patients with bone tumors of extremities were treated in our hospital. All the patients underwent CT scanning (1.0mm) before operation. The DICOM format data were obtained, the data were imported into Mimics 17.0 software, the three-dimensional model was edited, the osteotomy position was determined on the model, and the pore size, density and porosity of the implant, including titanium alloy prosthesis, were designed to match the remaining bone tissue. The new ligaments are more beautiful. The prognosis of the patients was evaluated by using the international skeletal muscle tumor limb salvage (MSTS) score system during follow-up. [results] all the patients were followed up for 4 ~ 25 months with an average of 13.2 months. X-ray examination showed that the residual bone tissue matched well with the tumor prosthesis, no loosening and osteolysis of the prosthesis, no recurrence or metastasis of the tumor. At the last follow-up, the MSTS score was 17 ~ 28, with an average of 25.7, of which 3 were excellent, 2 were good and 1 was fair. The excellent and good rate was 83.3%. [conclusion] through the application of 3D printing technology, the precise osteotomy range can be determined, the individualized joint prosthesis can be designed, the aperture, density and porosity of titanium alloy prosthesis can be adjusted, and the individualized ligament attachment point can be designed on the prosthesis. It provides a new method for the treatment of bone tumors in extremities.
【作者单位】： 北华大学附属医院骨外科二疗区;
【分类号】：R738;TP391.73
[Abstract]:Objective: to explore a new method of 3D printing prosthesis for large joint tumor of extremities. [methods] from January 2014 to May 2016, 6 patients with bone tumors of extremities were treated in our hospital. All the patients underwent CT scanning (1.0mm) before operation. The DICOM format data were obtained, the data were imported into Mimics 17.0 software, the three-dimensional model was edited, the osteotomy position was determined on the model, and the pore size, density and porosity of the implant, including titanium alloy prosthesis, were designed to match the remaining bone tissue. The new ligaments are more beautiful. The prognosis of the patients was evaluated by using the international skeletal muscle tumor limb salvage (MSTS) score system during follow-up. [results] all the patients were followed up for 4 ~ 25 months with an average of 13.2 months. X-ray examination showed that the residual bone tissue matched well with the tumor prosthesis, no loosening and osteolysis of the prosthesis, no recurrence or metastasis of the tumor. At the last follow-up, the MSTS score was 17 ~ 28, with an average of 25.7, of which 3 were excellent, 2 were good and 1 was fair. The excellent and good rate was 83.3%. [conclusion] through the application of 3D printing technology, the precise osteotomy range can be determined, the individualized joint prosthesis can be designed, the aperture, density and porosity of titanium alloy prosthesis can be adjusted, and the individualized ligament attachment point can be designed on the prosthesis. It provides a new method for the treatment of bone tumors in extremities.
【作者单位】： 北华大学附属医院骨外科二疗区;
【分类号】：R738;TP391.73
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