3D打印多孔钽金属治疗发育性髋关节发育不良:现状及应用前景

3D printed porous tantalum metal in the treatment of developmental dysplasia of the hip:current status and application prospect

背景:发育性髋关节发育不良患者常有一个浅髋臼、笔直狭窄的股骨管等解剖结构的广泛扭曲,尤其是面对高度脱位的发育性髋关节发育不良患者,实施手术治疗时具有很大的挑战性。近年来,3D打印多孔钽金属个体化治疗发育性髋关节发育不良的效果及预后较好,可用于术前诊断、术前手术规划、术中建立3D导航模板、明确术前髋臼严重程度及术后髋臼重建矫正评估,具有良好的发展前景。目的:探讨3D打印多孔钽金属治疗髋关节发育不良的最新研究进展。方法:采用计算机检索中国知网、PubMed、MDPI、BMC Biotechnology、Web of Science和Springer link数据库中有关3D打印多孔钽金属个体化治疗发育性髋关节发育不良的研究资料,检索时限为1970-2022年。根据纳入和排除标准,最终共选取58篇文献进行综述。结果与结论:(1)多孔钽金属主要有生物兼容性、骨整合性和骨诱导性等生物学特性及生物力学特性,有效地促进了新骨、新的血管及神经的良好生长。(2)3D打印多孔钽金属是由3D打印成型技术、天然金属材料-多孔钽金属联合运用方案,目前主要在发育性髋关节发育不良及髋关节骨缺损患者中评价这一方案的有效性。(3)3D打印多孔钽金属良好的术前计划能有效改善发育性髋关节发育不良、髋关节骨缺损的术后效果,并为假体植入物做好术前个体化规划的准备,能有效避免术中障碍和充分解决患者特异性畸形,直接影响手术结果,应用前景较好。(4)目前,应用3D打印多孔钽金属个体化治疗发育性髋关节发育不良的短期疗效在动物模型及部分文献中得到验证,但缺乏中长期随访结果。

BACKGROUND:Patients with developmental dys plasia of the hip often have extensive distortion of anatomical structures such as shallow acetabulum and straight and narrow femoral canal.Especially in the face of developmental dys plasia of the hip patients with high dislocation,the implementation of surgical treatment is ve ry challenging.In recent years,the effect and prognosis of individualized treatment of developmental dysplasia of the hip with 3D printed porous tantalum metal are good.It can be used for preoperative diagnosis,preoperative surgical planning,intraoperative establishment of 3D navigation template,determination of preoperative acetabular seve rity and postoperative acetabular reconstruction and correction evaluation.It has a good development prospect.OBJECTIVE:To investigate the latest research progress of 3D printed porous tantalum metal in the treatment of developmental dys plasia of the hip.METHODS:The research data on individualized treatment of developmental dysplasia of the hip by 3D printed porous to ntalum metal were searched on the databases of CNKI,PubMed,MDPI,BMC Biotechnology,Web of Science,and Springer link by computer.Retrieval time was from 1970 to 2022.Acco rding to the inclusion and exclusion criteria.58 articles were selected for review.RESULTS AND CONCLUSION:(1)Porous tantalum metal has biological and biomechanical properties such as biocompatibility,bone integration and bone inductance,which can effectively promote the growth of new bone,new blood vessels and nerves.(2)3D printed porous tantalum is a combined application of 3D printing molding technology and natural metal mate rials and porous tantalum.Currently,the effectiveness of this program is mainly evaluated in patients with developmental dys plasia of the hip and hip bone defects.(3)Good preoperative planning of 3D printed porous tantalum metal can effectively improve the postoperative outcomes of developmental dys plasia of the hip and hip bone defects,and prepare for the preoperative individualized planning of prosthetic implants,effectively avoid intraope rative obstacles and fully solve patient-specific malformations,and directly affect the surgical results.The application prospect is good.(4)Currently,animal models and some articles have verified the short-term efficacy of 3D-printed porous to ntalum metal in the individualized treatment of developmental dys plasia of the hip,but medium and long-term follow-up results are lacking.