中国医学创新2023，Vol.20Issue(34)：12-17,6.DOI:10.3969/j.issn.1674-4985.2023.34.003
3D打印技术在自体骨植骨的全髋关节置换术治疗髋关节发育不良继发骨性关节炎中的应用
Application of 3D Printing Technology in Total Hip Arthroplasty with Autogenous Bone Grafting for Osteoarthritis Secondary to Developmental Dysplasia of the Hip
摘要
Abstract
Objective:To investigate the application of 3D printing technology in total hip arthroplasty(THA)with autogenous bone grafting in the treatment of osteoarthritis secondary to developmental dysplasia of the hip(DDH).Method:The clinical data of 48 patients with osteoarthritis secondary to Crowe type Ⅱ-Ⅳ adult DDH who underwent THA with autogenous bone grafting reconstruction acetabular therapy for the first time in the Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2021 were retrospectively analyzed.According to the random number table method,they were divided into an observation group and a control group,with 24 cases in each group.In the observation group,3D printing technology was used to make pelvic models and navigation templates for preoperative planning and intraoperative operation guidance.In the control group,preoperative planning and intraoperative operation were performed according to imaging data.The perioperative related indicators(operation time,intraoperative blood loss,acetabular component coverage rate,bone graft coverage rate,and qualified rate of cup position)and postoperative imaging related measurement indicators(the difference values between the acetabular component size,abduction angle,anteversion angle,vertical and horizontal distance of the center of rotation and the preoperative surgical plan),Harris hip function score,complications(venous thrombosis,sciatic nerve injury,heterotopic ossification),and three-dimensional gait parameters(stride frequency,stride length,gait speed,and knee joint motion angles),were compared between the two groups.Result:The operation time of the observation group was shorter than that of the control group,the intraoperative blood loss was significantly less than that of the control group,the acetabular component coverage rate and bone graft coverage rate were significantly higher than those of the control group,the differences were statistically significant(P<0.05);there was no significant difference in the qualified rate of cup position between the two groups(P>0.05).The differences of the difference values between the acetabular component size,abduction angle,anteversion angle,vertical and horizontal distance of the center of rotation and the preoperative surgical plan at 1 week after operation were significantly smaller than those in the control group,the differences were statistically significant(P<0.05);1 week after operation,the Harris hip function scores of the two groups were significantly higher than those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).At 6 and 12 months after operation,three-dimensional gait parameters(stride frequency,stride length,gait speed,and knee joint motion angles)of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:THA with autogenous bone graft assisted by 3D printing technology and traditional THA can both achieve good repair results in the treatment of osteoarthritis secondary to DDH in adults,but 3D printing technology can significantly reduce the operation time and intraoperative blood loss,improve the accuracy of total hip arthroplasty,and contribute to the recovery of hip joint and the improvement of postoperative gait.关键词
3D打印技术/全髋关节置换术/髋关节发育不良Key words
3D printing technology/Total hip arthroplasty/Developmental dysplasia of the hip引用本文复制引用
裴方,赵蕤,姚圣城,仇尚..3D打印技术在自体骨植骨的全髋关节置换术治疗髋关节发育不良继发骨性关节炎中的应用[J].中国医学创新,2023,20(34):12-17,6.基金项目
徐州医科大学附属医院2021年度院级科研项目(2021ZA20) （2021ZA20）
