3D打印在伴有股骨侧关节外畸形初次膝关节置换术中应用体会

3D printing technology in the primary total knee arthroplasty with severe extra-articular femoral deformity

目的探讨3D打印技术在伴有股骨侧关节外畸形的初次全膝关节置换术（TKA）中的应用。方法选取沈阳军区总医院自2013年7月至2016年1月收治的伴有股骨侧关节外畸形患者8例,应用3D打印技术辅助初次膝关节置换。结果所有8例患者均获得1-3年的随访。HSS评分由术前的平均34.5分提高至术后的平均87.0分。下肢机械轴线由术前的平均内翻偏移14.6°改善至术后的平均内翻偏移2.1°。未见感染,骨延迟愈合、不愈合,血栓栓塞等并发症,中远期疗效良好。结论应用3D打印技术辅助的TKA可有效恢复下肢机械轴线,并且能够简化手术过程、缩短手术时间,术后临床效果满意。

Objective To explore 3D printing technology in the primary total knee arthroplasty（ TKA） with severe extra-articular femoral deformity. Methods A retrospective study was performed on 8 patients with severe extra-articular femoral deformity who received 3D printing technology in the primary TKA in The General Hospital of Shenyang Military Command from July 2013 to January 2016. Results All 8 patients received 1-3 years of follow up. The mean HSS score increased from preoperative 34. 5 points to postoperative 87. 0 points. The average deviation of mechanical axis of lower limb was improved from preoperatively 14. 6°of varus excursion to postoperative 2. 1°of varus excursion. No complications such as infection,delayed union,nonunion or DVT were found,the medium and long term curative effect was good. Conclusion The application of 3D printing technology assisted TKA can effectively restore limb mechanical axis,simplify the operation process,shorten the operation time,and postoperative clinical effect is satisfactory.