前交叉韧带重建中个性化导板设计及精度评价

Design and accuracy evaluation of personalized navigation template in anterior cruciate ligament reconstruction

前交叉韧带损伤患者需及时进行重建手术修复治疗,而手术关键之一在于植入物隧道的定位。针对植入物隧道定位对医技要求高的问题,采用逆向工程和快速成型技术设计制作个性化导航模板辅助治疗前交叉韧带双束重建,为患者制定个性化的手术方案。结合术前虚拟规划、1∶1假体模拟手术和临床术后三者隧道的位置来评价该导航模板的定位精度和手术质量。结果显示,临床术后测量胫骨端前内侧束中心点占胫骨平台前后边缘和内外侧边缘最大距离的百分比为34.61%和45.87%,在参考数据37.6%±3.6%和46.5%±3.2%范围内;后外侧束中心点所占百分比为46.41%和50.28%,也在参考数据50.1%±5.0%和51.2%±2.4%范围内。表明该方法能有效地简化手术操作,且该导航模板的定位精度较高。

Patients with injury of anterior cruciate ligament need to be repaired by the reconstruction surgery in time,and one of the keys to the surgery is the tunnel placement of implant. For the problem of implant tunnel placement depending on higher requirements of medical technology,personalized navigation template based on reverse engineering and rapid prototyping technology was used as aids to treat double-bundle reconstruction of anterior cruciate ligament,and personalized surgical plans were made for patients. In addition,the positioning accuracy of navigation template and operation quality were evaluated by combining the positions of the virtual preoperative planning,the simulated surgery based 1∶ 1 prosthesis and the postoperative clinical tunnel together. The results show that,in the clinical postoperative measurement,the center of anterior-medial bundle of tibia accounts for maximum distance of the tibia platform between the front and back edge,inside and out-side edge 34. 61% and 45. 87%, within the scope of reference data 37. 6% ± 3. 6% and37. 6% ± 3. 2%; In the same way,the center of posterolateral bundle of tibia accounts for 46. 41%and 50. 28%,within the scope of reference data 50. 1% ± 5. 0% and 51. 2% ± 2. 4%,too. To sum up,this method can simplify the operation,and the location accuracy of the navigation template is high.