3D打印技术在成人CroweⅣ型发育性髋关节脱位关节置换中的临床应用

Clinical application of three dimension printing technology in total hip arthroplasty of Crowe Ⅳ developmental dislocation of the hip

目的探讨3D打印技术在成人CroweⅣ型发育性髋关节脱位(developmental dislocation of the hip,DDH)关节置换手术中的可行性及临床价值。方法成人CroweⅣ型DDH患者7例,进行双侧髋关节薄层CT扫描,使用专业软件处理所获的DICOM图像,重建双髋立体图像,再应用3D技术打印。术前利用3D打印模型确定假臼与真臼的位置,预估髋臼与股骨假体型号;利用模型进行股骨模拟截骨。利用Harris髋关节评分系统评价手术的临床疗效。根据骨盆平片及患髋正、侧位X线片观察髋臼、股骨假体的位置。结果 3D打印模型能够直观地确定假臼与真臼的位置,立体地呈现股骨头与股骨近端骨质结构改变,术中髋臼与股骨假体所用型号与术前规划基本一致。结论 3D打印技术用于成人CroweⅣ型DDH关节置换的术前规划,可行性好,术前可常规开展。

Objective To explore the feasibility and clinical significance of three dimension （3 D）printing technology in total hip arthroplasty of Crowe 1V developmental dislocation of the hip. Methods A total of 7 cases of Crowe 1Vdevelopmental dislocation of the hip were included in this study. All the patients accepted the CT scanning of the hip, and the DICOM images were processed by professional software. The 3 D image of the hip was sent to the 3 D printer. When the 3 D model of the hip was got, it was used to direct the preoperation planning. Harris scores system was taken to assess the clinical efficacy and excellent rate. Radiographic evaluation was based on the pelvic plain films, neutral and lateral X-ray of the hip. Results The 3D model of the hip could directly display the false and the real acetabulum,and visu- ally presented the deformation of the proximal femora. The prosthesis used in the operation was similar to the predicted one. Conclusion The 3D printing was feasible and significant in the preoperation planning in total hip arthroplasty of Crowe IV developmental dislocation of the hip. It could be suggested as a regular test of the operation.