3D打印技术在全膝关节置换术中的临床应用研究

Clinical application of 3D printing technique in total knee arthroplasty

目的研究3D打印技术辅助全膝关节置换术在膝关节骨关节炎治疗中的应用。方法对收治的拟行初次全膝关节置换术患者50例,随机分为3D打印技术组(运用3D打印截骨导板行全膝关节置换术)和常规技术组(应用传统技术行全膝关节置换术)。对2组患者术前、术后KSS评分、手术时间、术中及术后出血量、术后下地时间、术后疼痛评分、出院时间等多项指标进行分析。结果 3D打印技术组手术时间、术后出血量及住院天数明显低于常规技术组(P<0.05);术后1个月VAS评分,3D打印组技术明显优于常规技术组;术中出血量及术后3、6个月的VAS评分,2组间比较差异无统计学意义(P>0.05);术后1个月及3个月的KSS评分3D打印技术组明显高于常规技术组(P<0.05);术后6个月的KSS评分,2组比较差异无统计学意义(P>0.05)。结论 3D打印技术可提供更科学的术前计划、更精准的截骨和假体安置、更微创的手术操作、更有效的医患沟通,从而获得更加满意的疗效。

Objective To study the application of total knee arthroplasty(TKA) assisted by three-dimensional(3 D)printing technology in the treatment of knee osteoarthritis(KOA).Methods 50 patients undergoing primary total knee arthroplasty were randomly divided into two groups:three-dimensional technique group(using 3 D print osteotomy guide plate for total knee arthroplasty) and conventional technique group(traditional technique for total knee arthroplasty). The preoperative and postoperative KSS scores and operation time of the two groups were evaluated. Intraoperative and postoperative bleeding volume,postoperative time to the ground,postoperative pain score,discharge time and so on were statistically analyzed.Results The operation time,bleeding volume and hospitalization days in the 3 D printing group were significantly lower than those in the conventional technique group(P<0.05);The VAS score in the 3 D printing group was significantly better than that in the conventional technique group within one month after operation. The intraoperative bleeding volume and VAS score in the 3 months and 6 months after operation had no statistical difference between the two groups(P>0.05);The KSS score in the 3-D printing group was significantly higher than that in the conventional technique group 1 month and 3 months after operation(P<0.05). There was no significant difference in KSS score between the two groups at 6 months after operation(P>0.05).Conclusion 3 D printing provides us with more scientific pre-operative planning,more accurate osteotomy and prosthesis placement,more minimally invasive surgical procedures,and more effective doctor-patient communication,so as to obtain more satisfactory outcomes.