3D打印辅助髋关节置换术个体化治疗高原地区复杂髋关节疾病的临床观察

Clinical Observation of 3D Printing Assisted Hip Replacement in Individualized Treatment of Complex Hip Joint Diseases in Plateau Area

目的探讨3D打印辅助髋关节置换个体化治疗高原地区复杂髋关节病的临床疗效。方法回顾性分析2020年8月-2021年8月林芝市人民医院收治的9例高原地区复杂髋关节疾病患者临床资料。所有研究对象均进行3D打印辅助髋关节置换个体化治疗。观察患者手术时间、术中出血量、末次随访的髋关节Harris评分,术后测量髋臼假体置入外展角、前倾角,评估髋臼假体置入的准确程度。结果结合术前的计划,所有患者的髋臼假体型号大小均与术前规划一致。手术时间65~121 min,平均手术时间(87.78±16.75)min;术中出血量100~300 ml,平均术中出血量(208.33±56.47)ml;术后髋臼假体的外展角36°~47°,平均术后髋臼假体的外展角(41.00±3.43)°;前倾角13°~20°,平均前倾角(15.89±2.23)°。随访时间6~12个月,平均随访时间(9.44±1.64)个月,末次随访时Harris髋关节评分为83~95分,平均评分(86.22±5.22)分。结论3D打印辅助髋关节置换术个体化治疗高原地区复杂髋关节疾病可以优化手术方案、缩短手术时间、减少术中出血、提高手术精确度和临床效果,在高原复杂髋关节疾病的手术治疗方面有较好的临床应用价值。

Objective To investigate the clinical effect of 3D printing-assisted hip replacement in individualized treatment of complex hip arthropathy in plateau areas.Methods A retrospective study was conducted on 9 patients with complex hip joint disease in plateau areas treated with 3D printing-assisted total hip arthroplasty in Linzhi City People's Hospital from August 2020 to August 2021.All subjects underwent 3D printing-assisted hip replacement individualized treatment.The operation time,intraoperative blood loss and Harris hip score at the last follow-up were observed.The abduction angle and anteversion angle of acetabular prosthesis were measured after operation to evaluate the accuracy of acetabular prosthesis implantation.Results Combined with the preoperative planning,the size of the acetabular prosthesis in all patients was consistent with the preoperative planning.The operation time was 65-121 min,and the average operation time was(87.78±16.75)min.The intraoperative blood loss was 100-300 ml,with an average intraoperative blood loss was(208.33±56.47)ml.The abduction angle of acetabular prosthesis was 36°-47°,and the average abduction angle of acetabular prosthesis was(41.00±3.43)°.The anteversion angle was 13°-20°,and the average anteversion angle was(15.89±2.23)°.The follow-up time was 6-12 months,with an average follow-up time was(9.44±1.64)months.The Harris hip score at the last follow-up was 83-95 scores,with an average score was(86.22±5.22)scores.Conclusion 3D printing assisted hip arthroplasty for individualized treatment of complex hip joint diseases in plateau area can optimize the operation plan,shorten the operation time,reduce intraoperative bleeding,improve the operation accuracy and clinical effect,and has good clinical application value in the surgical treatment of complex hip joint diseases in plateau area.