3D打印技术在成年发育性髋关节发育不良患者股骨柄匹配度测量中的应用

Application of 3D printing technique in measurement of femoral stem matching in adult patients with the developmental dysplasia of hip

目的利用3D打印技术为成年发育性髋关节发育不良(DDH)患者股骨柄的选择提供参考。方法收集23例成年DDH患者(29髋),利用3D打印机制作全股骨模型,在同一模型中分别置入矩形柄和锥形柄髓腔锉,进行CT检查,比较两种形状股骨柄在股骨髓腔中4个位置处的匹配度。结果按照髓腔开口指数(CFI)分型,香槟型8髋,正常型11髋,烟囱型10髋。通过匹配度比较,香槟型更适合锥形柄(P<0.01),正常型在两种柄的匹配度上差异无统计学意义(P>0.05),而烟囱型与矩形柄更匹配(P<0.01)。结论通过3D打印技术,可以1∶1还原DDH患者股骨近端形态,对同一模型上模拟安装两种形状的股骨柄进行匹配度的比较,可以为人工全髋关节置换术中股骨柄的选择提供参考。

Objective To provide reference for the selection of femoral stem in adult patients with developmental dysplasia of hip(DDH)by using 3D printing technique.Methods Twenty-three adult patients(29 hips)with DDH were enrolled.The whole femur models were made by using a 3D printer.The same model was implanted into rectangular and tapered myelocavity file and CT scan was performed.The matching degree of two shapes of femoral stems at four positions of the femoral canal were compared.Results According to the classification of the medullary canal flare index(CFI),the champagne type was in 8 hips,the normal type was in 11 hips,and the chimney type was in 10 hips.Compared with the matching degree,the champagne type was more suitable for the tapered stem(P<0.01),and the normal type of femur cavity was matched by the two kinds of stems,there was no significant difference(P>0.05).The rectangular stem were more closely matched in the chimney type femur cavity(P<0.01).Conclusions Through the 3D printing technique,the proximal femoral morphology of DDH patients can be restored by 1∶1,and the matching degree of the two types of femoral stems can be simulated on the same model to provide a reference for the selection of femoral stems in total hip arthroplasty.