3D打印个性化截骨模具在人工全膝关节置换术中应用

3D printing individualized osteotomy mold in total knee arthroplasty

目的评价3D打印个性化截骨模具在人工全膝关节置换术(TKA)中的临床疗效。方法收集2014年4月至2016年6月收治的16例(20膝)应用3D打印个性化截骨模具行TKA患者为研究组(3D打印TKA组),再随机选取在此期间就诊的16例(19膝)应用常规截骨器械行TKA的患者为对照组(常规TKA组)。记录两组患者术后12 d的美国特种外科医院(HSS)膝关节评分、膝关节活动度及下肢力线的改善情况,评估术后并发症的发生情况。结果 3D打印TKA组术后12 d膝关节活动范围为(104.3°±15.5°),常规TKA组为(103.5°±12.5°),两组间比较,差异无统计学意义(P>0.05);3D打印TKA组术后12 d的HSS膝关节评分为(88.5±5.7)分,常规TKA组为(89.4±4.8)分,两组间比较,差异无统计学意义(P>0.05)。3D打印TKA组术后股骨与胫骨机械轴夹角为(2.9°±1.1°),常规TKA组为(3.0°±0.9°),两组间比较,差异无统计学意义(P>0.05)。两组患者均未出现术中和术后并发症。结论应用3D打印个性化截骨模具辅助行TKA手术的患者术后12 d膝关节功能、下肢力线和关节活动度的改善与常规行TKA手术的患者无明显差异。

Objective To explore the curative effect of 3D printing individualized osteotomy mold in total knee arthroplasty（ TKA）. Methods A retrospective study was performed on 16 patients（ 20 knees） from April 2014 to June 2016. Patients that were treated with TKA using 3D printing individualized osteotomy mold were divided into the experimental group（ 3D printing TKA group）,the other 16 patients（ 19 knees） that were treated with conventional TKA were randomly divided into the control group（ conventional TKA group）. The HSS score,range of motion（ ROM）,lower limb mechanical alignment and incidence of complication 12 days after operation were recorded. Results After 12 days,the postoperative ROM of knee in the 3D printing TKA group was（ 104. 3° ± 15. 5°） and that in the conventional TKA group was（ 103. 5° ± 12. 5°）,there was no significant difference between the two groups（ P〉0. 05）. HSS scores in 3D printing TKA group and in conventional TKA group were（ 88. 5 ± 5. 7） and（ 89. 4 ± 4. 8）,respectively,there was no significant difference between the two groups（ P〉0. 05）. Mechanical alignment in the 3D printing TKA group was（ 2. 9° ± 1. 1°） and that in conventional TKA group was（ 3. 0° ± 0. 9°）,there was no statistical significance（ P〉0. 05）. There was no obvious intraoperative and postoperative complication in the two groups. Conclusion There is no obvious difference between TKA with 3D printing individualized osteotomy mold and conventional TKA in HSS score,mechanical alignment and ROM of knee.