3D打印技术辅助人工全髋关节置换术治疗复杂髋部疾病效果分析

Effect analysis of 3D printing assisted total hip arthroplasty in the treatment of complex hip diseases

目的观察3D打印技术在复杂髋部疾病行全髋关节置换术中的应用效果。方法回顾性分析2017年1月~2021年3月汕头市第二人民医院52例行全髋关节置换术的单侧复杂髋部疾病患者,所有患者髋关节骨性关节炎严重性指数评分(ISOA)≥8分,K-L放射线分级为IV级。按照手术方法分为传统手术组和3D打印组,每组各26例。比较两组手术时间、术中出血量、术后12个月患髋关节Harris评分,比较两组患者术后髋臼假体位置相关影像学指标,记录两组患者术后并发症发生情况并进行比较。结果两组患者的性别、年龄、体重指数、术前视觉模拟量表(VAS)评分、术前患髋关节功能Harris评分差异无统计学意义(P>0.05)。3D打印组手术时间(95.8±8.15)min明显短于传统手术组(115.5±10.31)min,术中出血量(200.5±36.3)ml少于传统手术组(255.4±33.8)ml,差异有统计学意义(P<0.05)。术后髋臼假体位置影像学指标与健侧比较,3D打印组假体臼杯的前倾角、外展角、髋关节旋转中心的垂直距离和水平距离差异均无统计学意义(P>0.05)。传统手术组术后上述指标与健侧比较差异有统计学意义(P<0.05)。两组患者术后12个月随访时患髋关节Harris评分差异无统计学意义(P>0.05)。结论3D打印技术辅助复杂髋关节疾病THA治疗能缩短手术时间,减少术中出血,降低术中的不确定性,提高手术精准性,值得临床应用。

Objective To observe the effect of 3D printing technology in total hip arthroplasty for complex hip diseases.Methods 52 patients with unilateral complex hip diseases who underwent total hip arthroplasty were analyzed retrospectively.All patients had ISOA≥8 points and K-L radiation grade is IV.According to the operation method,they were divided into traditional operation group and 3D printing group,with 26 cases in each group.The operation time,intraoperative bleeding and Harris score of hip joint 12 months after operation were compared between the two groups.The imaging indexes related to the position of acetabular prosthesis were compared between the two groups.The incidence of postoperative complications was recorded and compared between the two groups.Results There was no significant difference in gender,age,BMI,preoperative VAS pain score and preoperative Harris score of hip function between the two groups(P>0.05).The operation time of 3D printing group(95.8±8.15)min was significantly shorter than that of traditional operation group(115.5±10.31)min,and the amount of intraoperative bleeding(200.5±36.3)mL was less than that of traditional operation group(255.4±33.8)mL.Compared with the healthy side,there was no significant difference in the anteversion angle,abduction angle,vertical distance and horizontal distance of hip rotation center in the 3D printing group(P>0.05).There was significant difference in the above indexes between the traditional operation group and the healthy side(P<0.05).There was no significant difference in Harris score of hip joint between the two groups at 12-month follow-up(P>0.05).Conclusion3D printing technology assisted the treatment of complex hip diseases can shorten the operation time,reduce intraoperative bleeding,reduce intraoperative uncertainty and improve the accuracy of operation.It is worthy of clinical application and promotion.