膝关节疾病应用3D打印技术:假体植入匹配与手术方案的规划

Three-dimensional printing technology applied in knee diseases: prosthesis matching and surgical planning

背景:作为新兴技术,3D打印技术已广泛应用于骨科领域,特别是膝关节疾病的手术治疗。3D打印技术显著提高了疾病诊断准确率和手术成功率,显著提升了患者满意度。目的:归纳3D打印技术在膝关节疾病治疗中的应用效果及存在的问题。方法:利用计算机检索CNKI,Pub Med数据库,中文检索词为"3D打印技术,股骨远端骨折,胫骨平台骨折,膝关节骨性关节炎,膝关节肿瘤,关节置换"。英文检索词为"3D printing,distal femur fracture,fracture of tibial plateau,knee osteoarthritis,knee tumor,joint replacement"。检索时限为1999年7月至2018年7月。共检索到167篇文章,根据纳入与排除标准,最终纳入57篇文献进行综述。结果与结论:3D打印技术结合CT,MRI等影像技术可以打印出复杂形状的几何结构及与个体完全匹配的植入体,将其应用在股骨远端骨折、胫骨平台骨折、骨关节炎及膝关节肿瘤等的关节置换手术中,显著提高了置换后患者的满意度和减少了并发症的发生。在促进医生与患者及家属的交流,提高疾病诊断率,规划手术方案及个体化治疗等方面也产生了深远的影响。

BACKGROUND： Three-dimensional （3D） printing, as a new technology, has been extensively applied in bones, especially the surgeries of knee diseases. 3D printing significantly improves the disease diagnosis accuracy, success rate of surgery and patients’ satisfaction. OBJECTIVE： To summarize the clinical outcomes and problems of 3D printing in the treatment of knee diseases. METHODS： CNKI and PubMed databases were retrieved with the keywords of “3D printing, distal femur fracture, fracture of tibial plateau, knee osteoarthritis, knee tumor, joint replacement” in English and Chinese, respectively, for the articles published from July 1999 to July 2018. Totally 167 articles were searched, and finally 57 eligible articles were enrolled for review in accordance with the inclusion and exclusion criteria. RESULTS AND CONCLUSION： 3D printing combined with CT and MRI can copy any complex structures and a fully matched prosthesis. Its application in the arthroplasty of distal femoral fracture, tibial plateau fractures, knee osteoarthritis, bone tumors has remarkably improved the postoperative patients’ satisfaction andreduced the postoperative complications. It plays an important role in helping the communication between doctors and patients, increasing the diagnosis accuracy, preoperative planning and individualized treatment.