髋关节翻修术应用3D打印植入物的研究进展

Research progress on 3D printing implants in acetabular defects of revision hip arthroplasty

随着全髋关节置换术的应用增多,假体松动、髋臼骨折以及翻修率也明显提高。在髋关节翻修术中髋臼侧骨缺损是临床医生最具有挑战性的处理,由于髋臼局部解剖的复杂性、形态不规则、缺损面积大小不一,常规固定尺寸的内植物不能与实际骨缺损实现较好匹配。此外,影响内植物与宿主骨融合的因素有骨长入、机械性能和全身疾患。3D打印技术以实际髋臼组织三维CT扫描数据为基础,经过MIMICS 18.0软件自动多种后处理技术,创建单独髋臼分离的3D解剖图像。在模型制作、手术导板、个性化假体、术前诊断、模拟和术中导航等方面均有重要的应用潜力。

With the increasing application of total hip arthroplasty,the rate of aseptic loosening,acetabular fracture and revision is also significantly improved.Acetabular bone defect is the most challenging treatment for clinicians in hip arthroplasty,because of the complexity,irregular shape and different size of acetabular local anatomy,conventional fixed-size implants can not match the actual bone defects.In addition,the factors affecting the fusion of the implant and the host bone are bone growth,mechanical properties and systemic diseases.3D printing technology is based on the actual acetabular tissue three-dimensional CT scanning data,through a variety of automatic post-processing techniques of Mimics 18.0 software to create a separate 3D anatomical image of the acetabulum.It has important application potential in model making,surgical guide plate,personalized prosthesis,preoperative diagnosis,simulation and intraoperative navigation.