3D打印导航模板辅助微创髓芯减压术联合自体骨移植治疗早期股骨头坏死的临床效果

Clinical effect of 3D printing navigation template assisted minimally invasive core decompression combined with autologous bone transplantation in the treatment of early osteonecrosis of femoral head

目的探讨3D打印导航模板辅助微创髓芯减压术联合自体骨移植治疗早期股骨头坏死(ONFH)的临床效果。方法将40例ONFH患者按入院先后顺序分为对照组(20例,微创髓芯减压术联合自体骨移植治疗)和研究组(20例,3D打印导航模板辅助微创髓芯减压术联合自体骨移植治疗)。比较两组的治疗效果。结果研究组的手术用时短于对照组,术中出血量、透视次数少于对照组,术后股骨头存活率高于对照组,股骨头塌陷率低于对照组(P<0.05)。术后3、6、12个月,研究组的视觉模拟评分法(VAS)评分显著低于对照组,髋关节功能评分高于对照组(P<0.05)。术后12个月,研究组的胰岛素样生长因子-1(IGF-1)、骨钙素(BGP)水平高于对照组,软骨寡聚基质蛋白(COMP)、核因子κB受体活化因子配基(RANKL)、人软骨糖蛋白39(YKL-40)水平低于对照组(P<0.05)。结论3D打印导航模板辅助微创髓芯减压术联合自体骨移植治疗早期ONFH的效果确切,临床可进一步推广及运用。

Objective To investigate the clinical effect of 3D printing navigation template assisted minimally invasive core decompression combined with autologous bone transplantation in the treatment of early osteonecrosis of femoral head(ONFH).Methods According to the order of admission,40 patients with ONFH were divided into control group(20 cases,minimally invasive core decompression combined with autologous bone transplantation)and study group(20 cases,3D printing navigation template assisted minimally invasive core decompression combined with autologous bone transplantation).The therapeutic effects of the two groups were compared.Results The operation time of the study group was shorter than that of the control group,the intraoperative blood loss and the number of fluoroscopy were less than those of the control group,the survival rate of the femoral head after operation was higher than that of the control group,and the collapse rate of the femoral head was lower than that of the control group(P<0.05).At 3,6 and 12 months after operation,the Visual Analogue Scale(VAS)score of the study group was significantly lower than that of the control group,and the hip joint function score was higher than that of the control group(P<0.05).At 12 months after operation,the levels of insulin-like growth factor-1(IGF-1)and osteocalcin(BGP)in the study group were higher than those in the control group,the levels of cartilage oligomeric matrix protein(COMP),receptor activator of nuclear factor-κB ligand(RANKL)and human cartilage glycoprotein 39(YKL-40)were lower than those in the control group(P<0.05).Conclusion The 3D printing navigation template assisted minimally invasive core decompression combined with autologous bone transplantation in the treatment of early ONFH has definite effect,which can be further promoted and applied in clinic.