3D建模与快速成型技术在个体化膝关节假体术中的应用

Application of 3D Modeling and Rapid Prototyping Technology in the Individualized Knee Prosthesis Operation

目的探讨3D建模与快速成型技术在个体化膝关节肿瘤假体手术治疗中的新方法,评价3D建模与快速成型技术的应用价值.方法选取3例膝关节骨肿瘤患者,术前均对膝关节周围病损区行CT扫描,获得原始数据后,导入Mimics19.0软件,在软件中模拟手术规划,并且设计与切除后剩余的骨组织相契合的钛合金"植物.随访期间应用国际骨与软组织肿瘤保肢(Musculoskeletal Tumor Society,MSTS)功能评分系统对患者的术后功能情况进行评价.结果 3例患者均获随访,随访时间5~26个月,平均16个月.末次随访MSTS得分为18~29分,平均24.3分,其中优2例,良1例,优良率达100%.结论通过3D建模与快速成型技术在膝关节肿瘤手术中的应用,可精确指导截骨界限,设计个体化膝关节假体,韧带附丽点接近生理结构,为膝关节骨肿瘤治疗提供新方法.

Objective To discuss the new method of 3 D modeling and rapid prototyping technology in the treatment of individual knee joint tumor prosthesis,and to evaluate the application value of 3 D modeling and rapid prototyping technology. Method 3 patients with bone tumor in knee joint were treated. CT scanning was performed on the area around the knee joint before operation,and the raw datum were imported into Mimics19. 0 software. Surgical plans were simulated in the software and the titanium alloy implants that match the remaining bone tissue after removal were designed. Musculoskeletal Tumor Society（ MSTS） scoring system was used to evaluate the postoperative function of the patients during the follow-up. Results All the patients were followed up for 5 ~ 26 months（ mean 16 months）. The MSTS score of the last follow-up was 18 ~ 29 scores. The average score was 24. 3,in which 2 cases were excellent,1 case was good,with the excellent rate of 100%.Conclusion The application of 3 D modeling and rapid prototyping technology in the operation of knee joint tumor can guide the precise osteotomy boundary,design individual knee joint prosthesis,and close to the physiological point of ligaments. It provides a new method for the treatment of knee bone tumor.