3D打印切模辅助全膝关节置换术的初步临床研究

Preliminary clinical study of 3D printing cutting block assisted total knee arthroplasty

目的探讨3D打印切模辅助全膝关节置换术的近期临床效果。方法将云南省曲靖市第一人民医院骨科2013年10月至2015年1月收治并符合本研究纳入标准的90例患者随机分为3D打印切模组与传统手术组。两组均行单侧膝关节置换术,记录两组患者手术时间、术中出血量、术后引流量、术前HGB、术后即刻HGB、输血量、术后3个月HSS评分,并进行影像学测量评估记录两组患者MFTA、LDFA、MPTA、STCA,采用SPSS13.0软件对所得数据进行统计分析,计量资料采用两独立样本t检验。结果所有患者均获得平均13.2个月随访,3D打印切模组及与传统手术组手术时间(45.5±4.5)min为(75.8±5.9)min、术中出血(100.7±16.7)m L为(460.7±22.9)m L、术后引流量(60.10±8.61)m L为(59.2±15.1)m L、术后即刻HGB(109.5±8.6)g/L为(89.9±9.4)g/L、术后3 d HGB(95.2±8.5)g/L为(82.5±6.3)g/L、总输血量0为(620.0±25.8)m L,差异均有统计学意义(P均小于0.05)。影像学评估MFTA(0.85±0.14)°vs(2.15±0.84)°、LDFA(85.2±0.21)°vs(84.3±0.15)°、MPTA(87.9±0.68)°vs(88.3±0.54)°、SCTA(2.79±0.32)°vs(4.21±0.47)°,差异均有统计学意义(P均小于0.05)。结论 3D打印切模辅助全膝关节置换术具有个性化、精准化、数字化、手术时间短、创伤小、出血少等优点,能显著改善下肢力线,近期临床疗效满意。

Objective To discuss the preliminary clinical effect of 3D Printing cutting block in total knee arthroplasty. Methods 90 patients who underwent unilateral knee replacement were randomly divided into two groups( 3D printing cutting block and conventional surgery group). The operation time,intraoperative blood loss, postoperative drainage, preoperative HGB, postoperative HGB instantly, blood transfusion volume and HSS scores 3 months after operation of the two groups were recorded. The imaging measurement including MFTA,LDFA,MPTA and STCA of the two groups patients was also recorded. The results were analyzed. Result All patients got an average of 13. 2 months follows-up. The Operation time,intra-operative bleeding volume,postoperative drainage and immediate postoperative HGB,HGB 3 days after operation and the total amount of blood transfusion were statistically significant differences. The imaging evaluation of MFTA and SCTA were statistically significant difference. Conclusion 3D printing cutting block in total knee arthroplasty possesses the advantages of personality,accuracy,digitization,shorter operation time,smaller trauma,less bleeding,and it can significantly improve the lower limb lines of force.The short-term clinical effect is satisfied.