3D打印技术在伴骨缺损髋关节置换(翻修)术中的应用
|
摘要
目的探讨3D打印技术在伴骨缺损髋关节置换(翻修)术中的应用效果。方法对15例伴骨缺损关节置换(翻修)患者术前通过3D打印技术构建模型,术中实施术前计划、完成重建及假体安置。记录手术时间、术中出血量、术后引流量;术后6个月测量髋臼杯外展角、前倾角;末次随访时采用髋关节Harris功能评分系统评价患髋功能情况。结果 15例均顺利完成手术。手术时间120～155 (135±20) min,术中出血量200～500 (440±65) ml,术后引流量200～500 (430±75) ml。1例术后并发坐骨神经牵拉损伤,术后2个月恢复。患者均获得随访,时间6～12个月。术后3个月股骨偏心距由术前33. 6～48. 0 mm增加到术后36. 0～55. 0 mm。术后6个月髋臼杯外展角40°～45°,前倾角15°～18°。末次随访时Harris评分为79～88分。结论 3D打印技术指导伴骨缺损髋关节置换(翻修)术可术前实现个性化设计,术中减少手术创伤,术后关节假体位置良好,髋关节功能可获得较大改善。
Objective To investigate the clinical effect of 3D printing technique in the hip replacement( revision)with bone defect. Methods Fifteen patients with bone defect joint replacement( revision) were selected. The model was constructed by 3D printing technique before operation. Preoperative planning was carried out during operation to complete reconstruction and prosthesis placement. These data were recorded,including operation time,intraoperative blood loss and postoperative drainage volume,acetabular cup abduction angle,antiversion angle at postoperative 6 months. At the last follow-up,Harris score of hip joint was used to evaluate hip function. Results The operation of15 patients was completed successfully. The operation time was 120 ～ 155( 135 ± 20) min,intraoperative bleeding was200 ～ 500( 440 ± 65) ml. Postoperative drainage was 200 ～ 500( 430 ± 75) ml. A case had sciatic nerve traction injury after operation,and rocovered at 2 months postoperation. All cases were followed up for 6 ～ 12 months. The eccentricity of femur was increased from 33. 6 ～ 48. 0 mm preoperatively to 36. 0 ～ 55. 0 mm at postoperative 3 months. At 6 months postoperation,measurement of acetabular cup abduction angle was 40° ～ 45° and antiversion angle was 15° ～18°. The Harris score for the last follow-up was 79 ～ 88 points. Conclusions Under the guidance of 3 D printing technique,the hip replacement or revision operation with bone defect is accurate,the position of joint prosthesis is good,and the function of hip joint is improved greatly.
Objective To investigate the clinical effect of 3D printing technique in the hip replacement( revision)with bone defect. Methods Fifteen patients with bone defect joint replacement( revision) were selected. The model was constructed by 3D printing technique before operation. Preoperative planning was carried out during operation to complete reconstruction and prosthesis placement. These data were recorded,including operation time,intraoperative blood loss and postoperative drainage volume,acetabular cup abduction angle,antiversion angle at postoperative 6 months. At the last follow-up,Harris score of hip joint was used to evaluate hip function. Results The operation of15 patients was completed successfully. The operation time was 120 ～ 155( 135 ± 20) min,intraoperative bleeding was200 ～ 500( 440 ± 65) ml. Postoperative drainage was 200 ～ 500( 430 ± 75) ml. A case had sciatic nerve traction injury after operation,and rocovered at 2 months postoperation. All cases were followed up for 6 ～ 12 months. The eccentricity of femur was increased from 33. 6 ～ 48. 0 mm preoperatively to 36. 0 ～ 55. 0 mm at postoperative 3 months. At 6 months postoperation,measurement of acetabular cup abduction angle was 40° ～ 45° and antiversion angle was 15° ～18°. The Harris score for the last follow-up was 79 ～ 88 points. Conclusions Under the guidance of 3 D printing technique,the hip replacement or revision operation with bone defect is accurate,the position of joint prosthesis is good,and the function of hip joint is improved greatly.
引文
[1] Yoon P W,Kim J L,Kim D O,et al. Cementless total hip arthroplasty for patients with Crowe typeⅢorⅣdevelopmental dysplasia of the hip:two-stage total hip arthroplasty following skeletal traction after soft tissue release for irreducible hips[J]. Clin Orthop Surg,2013,5(3):167-173.
[2]王岩.人工髋关节翻修术的发展趋势及国内现状的思考[J].中华外科杂志,2012,50(5):385-388.
[3]官建中,刘亚军,吴敏,等. 3D打印技术在成人DDH人工全髋关节置换术中的临床应用研究[J].中华全科医学,2016,14(7):1080-1082.
[4]王利,米尔阿里木·木尔提扎,赵巍.结合3D打印技术治疗严重髋臼缺损的髋关节翻修术一例[J/CD].中华关节外科杂志(电子版),2016,10(5):580-581.
[2]王岩.人工髋关节翻修术的发展趋势及国内现状的思考[J].中华外科杂志,2012,50(5):385-388.
[3]官建中,刘亚军,吴敏,等. 3D打印技术在成人DDH人工全髋关节置换术中的临床应用研究[J].中华全科医学,2016,14(7):1080-1082.
[4]王利,米尔阿里木·木尔提扎,赵巍.结合3D打印技术治疗严重髋臼缺损的髋关节翻修术一例[J/CD].中华关节外科杂志(电子版),2016,10(5):580-581.