3D打印截骨模板在老年膝关节骨性关节炎全膝关节置换术中的应用

Application of 3D-printed osteotomy template in total knee arthroplasty for elderly patients with knee osteoarthritis

目的探讨3D打印截骨模板辅助全膝关节置换术(TKA)治疗老年膝关节骨性关节炎(KOA)的效果。方法选取2020年3月—2021年5月就诊于江门市新会区人民医院KOA患者60例,采用区组随机分组法分为观察组(30例)、对照组(30例)。观察组实施3D打印截骨模板辅助TKA术,对照组实施TKA术。比较两组的手术时间(OT)、术中出血量(IBV)、术后24 h引流量(24 h PDV)及住院时间,手术前后膝关节功能[采用美国特种外科医院(HSS)评分]及膝关节活动度(屈曲、外旋、内旋),术后步长及步行速度,旋转对线偏移率,术后并发症。结果与对照组相比,观察组OT短,IBV、24 h PDV少(P均<0.05);观察组术后4、8周的HSS评分高、膝关节活动度大、步长长、步行速度快(P均<0.05)。观察组旋转对线偏移率为3.33%(1/30)、术后并发症发生率为3.33%(1/30),与对照组[20.00%(6/30)、6.67%(2/30)]比较差异无统计学意义(P均>0.05)。结论3D打印截骨模板辅助TKA术治疗KOA患者,可改善膝关节功能及步态状态,安全可靠。

Objective To analyze the clinical value of 3D-printed osteotomy template assisted total knee arthroplasty(TKA)in the treatment of elderly knee osteoarthritis(KOA).Methods A total of sixty patients with KOA from March 2020 to May 2021 in Xinhui District People's Hospital of Jiangmen City were selected and divided into observation group(n=30)and control group(n=30)using the district group randomization method.The 3D-printed osteotomy template assisted TKA was performed in the observation group and TKA was performed in the control group.The operating time(OT),intraoperative bleeding(IBV),24 h postoperative drainage(24 h PDV)and length of hospital stay,knee function(HSS)score and knee mobility(flexion,external rotation,internal rotation),postoperative stride length and walking speed,rotation alignment offset rate,and postoperative complications were compared.Results Compared with the control group,the observation group had shorter OT,less IBV and 24 h PDV(all P<0.05).At 4 and 8 weeks after operation,compared with the control group,the observation group had higher HSS score,greater range of motion of the knee joint,longer stride length and faster walking speed(all P<0.05).The rotational alignment excursion rate of observation group had 3.33%(1/30),and the incidence rate of postoperative complication was 3.33%(1/30).There was no significant difference compared with the control group[20.00%(6/30),6.67%(2/30)](P>0.05).Conclusion 3Dprinted osteotomy template assisted TKA for KOA patients can improve knee function and gait status with safety and reliability.