三维打印导板辅助关节镜下微创踝关节融合术治疗晚期踝关节炎患者的临床研究

Clinical Study of Minimally Invasive Arthroscopic Ankle Joint Fusion Assisted by Three-Dimensional Printing Guide Palet in the Treatment of Patients with Advanced Ankle Arthritis

目的:探讨三维打印导板辅助关节镜下微创踝关节融合术治疗晚期踝关节炎患者的临床价值。方法:选取2022年1月—2023年10月中国人民解放军东部战区海军医院收治的92例晚期踝关节炎患者为研究对象,以随机数字表法将其分为对照组和研究组,各46例。对照组采用常规手术治疗,研究组采用三维打印导板辅助关节镜下踝关节融合术治疗。比较两组临床指标、血生化指标、踝关节恢复情况及并发症发生情况。结果:研究组的手术总用时长于对照组,住院时长、关节融合时间均短于对照组,术中透视次数少于对照组,差异均有统计学意义(P<0.05)。术后第3天,研究组血生化指标均低于对照组,差异均有统计学意义(P<0.05)。术后6个月,两组的踝关节恢复情况评分对比,差异均无统计学意义(P>0.05)。研究组并发症发生率为6.52%,低于对照组的8.70%,但两组并发症发生率对比,差异均无统计学意义(P>0.05)。结论:治疗晚期踝关节炎患者时,应用三维打印导板辅助关节镜下微创踝关节融合术进行治疗,虽然会延长手术总用时,但可减少术中透视次数,缩短关节融合及住院时间,降低手术治疗后的炎症反应,具有一定的安全性。

Objective:To explore the clinical value of minimally invasive arthroscopic ankle joint fusion assisted by three-dimensional printing guide palet in the treatment of patients with advanced ankle arthritis.Methods:A total of 92 patients with advanced ankle arthritis admitted to the Naval Hospital of Eastern Theater Command of Chinese People’s Liberation Army from January 2022 to October 2023 were selected as the study objects,were divided into a control group and a study group with 46 cases in each group by random number table method.The control group was treated with traditional open surgery,and the study group was treated with minimally invasive arthroscopic ankle joint fusion assisted by three-dimensional printing guide plate.The clinical indexes,blood biochemical indexes,ankle recovery scores and accurrence of complications were compared between the two groups.Results:The total operation time of the study group was longer than that of the control group,the hospitalization time and joint fusion time were shorter than that of the control group,the intraoperative fluoroscopy times were less than that of the control group,the differences were statistically significant(P<0.05).On the third day after surgery,the blood biochemical indexes of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).Six months after surger,there was no significant difference in ankle recovery scores between the two groups(P>0.05).The complication rate in the study group was 6.52%,which was lower than 8.70%in the control group,but there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:In the treatment of patients with advanced ankle arthritis,the application of three-dimensional printing guide palet assisted minimally invasive arthroscopic ankle fusion can prolong the total surgical time,but can reduce the number of intraoperative fluoroscopy,shorten joint fusion and hospital stay,reduces inflammation after surgery,which has certain safety.