3D打印技术在髋关节置换中的应用及价值

Application and progress of three-dimensional printing technology in hip arthroplasty

背景:3D打印技术是一种新型的快速成型技术,其在骨科已得到初步应用,特别是在髋关节置换的临床应用中日益深入。目的:总结3D打印技术在髋关节置换术中的应用现状、存在问题及未来的发展方向。方法:检索2000年1月至2019年3月期间PubMed数据库、中国知网(CNKI)、万方数据库(WF),中文检索词为“3D打印技术,快速成型,增材制造,计算机辅助,髋关节,关节置换,翻修”;英文检索词为“3D printing,rapid prototyping,additive manufacturing,computer aided,computer-assisted,hip,hip replacement,hip arthroplasty,revision hip arthroplasty”。初检文章1833篇,根据纳排标准,最终纳入105篇文章进行综述分析。结果与结论:①在髋关节置换领域中,3D打印技术主要用于制作临床教学或术前规划用的解剖模型、手术辅助导板、个体化的植入物或假体等;②3D打印技术的优势可以弥补传统治疗的不足,优化手术方案、缩短手术时间及出血、减少术后并发症、提高手术精确度和临床效果;③利用3D打印技术进行个体化治疗将成为髋关节置换领域的新方向。

BACKGROUND:Three-dimensional(3D)printing technology is a new rapid prototyping technology,which has been initially applied in orthopedics,especially in the clinical application of hip replacement surgery.OBJECTIVE:To summarize the application status,existing problems and future development direction of 3D printing technology in hip arthroplasty.METHODS:The relevant articles published between January 2000 and March 2019 were retrieved from PubMed,CNKI and WanFang databases.The keywords were“3D printing,rapid prototyping,additive manufacturing,computer aided,computer-assisted,hip,hip replacement,hip arthroplasty,revision hip arthroplasty”in English and Chinese,respectively.Initially,1833 articles were retrieved,and finally 105 eligible articles were included for result analysis in accordance with the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)In the clinical application of hip replacement surgery,3D printing technology is mainly used to make anatomical models for clinical teaching or preoperative plan,patient-specific surgical guides,customized implants or prostheses.(2)The advantages of 3D printing technology can make up for the deficiency of traditional treatment,and it can help to optimize the surgical plan,shorten the operation time,decrease the bleeding,reduce postoperative complications,improve the accuracy of surgery and clinical results.(3)Individualized treatment with 3D printing technology will become a new direction in hip arthroplasty.