中国骨伤2025，Vol.38Issue(2)：163-169,7.DOI:10.12200/j.issn.1003-0034.20230723
3D打印个体化定制假体在合并严重骨缺损髋关节翻修中的早期临床疗效
Early clinical outcomes of 3D-printed individualised customised prostheses in hip revision combined severe bone defect
摘要
Abstract
Objective To explore the early clinical outcomes of 3D printed individualised customised prostheses for in hip revision in patients with combined severe bone defects.Methods Twenty-two patients from January 2021 to May 2023 under-went hip revision using 3D printed personalised customised prostheses were retrospective analyzed,including 10 males and 12 females,age 28 to 78 with a mean of(58.9±12.8)years old.All of patients were combined with severe bone defects(Parprosky type Ⅲ).Among of them,9 patients had periprosthetic infections and 13 patients had aseptic prosthesis loosening.All patients were treated with a 3D printed personalised prosthesis protocol,patients with the periprosthetic infection received a second stage revision after infection control.The operation time,preoperative waiting time,intraoperative and postoperative complica-tions were recorded,and the clinical efficacy were evaluated at the final follow-up using the visual analogue scale(VAS)for pain,the Harris hip score.Results One patient was lost to follow-up and the remaining 21 patients were followed up for 10 to 15 with a mean of(12.91±1.44)months after surgery.All patients completed surgery as planned,with an operative time of 135 to 390 with a mean of(165.4±39.3)minutes and a preoperative waiting time of 7 to 16 with a mean of(10.5±3.3)days.Regard-ing patient complications:one patient had a severe intraoperative periprosthetic femoral fracture due to the combination of se-vere osteoporosis;one patient had an intraoperative greater trochanteric femur fracture.At the latest follow-up,all patients had good position of the custom-made prosthesis and no loosening of the prosthesis;all patients had good wound healing and no lo-cal redness or swelling.The total Harris score at the final follow-up(85.86±7.04)was significantly improved compared to the preoperative(44.86±2.36),P＜0.001.The VAS at the last follow-up(2.19±0.87)was significantly improved compared with preoperative(7.41±0.96),P＜0.001.Conclusion The clinical efficacy of 3D-printed personalised customised prosthesis in combined severe bone defect hip revision is satisfactory,but due to the increased preoperative waiting time of the patients and certain risks,certain indications should be mastered when applying in the clinic.关键词
3D打印/个体化定制/假体/严重骨缺损/髋关节翻修/临床疗效Key words
3D printing/Individual customization/Prosthesis/Severe bone defect/Hip revision/Clinical outcomes分类
临床医学引用本文复制引用
王洪平,王明友,杨晓琴,唐茁栋,宋训洲,兰玉平..3D打印个体化定制假体在合并严重骨缺损髋关节翻修中的早期临床疗效[J].中国骨伤,2025,38(2):163-169,7.基金项目
2023年四川省医学会骨科(尚安通)专项科研课题(编号:2023SAT14)2023 Sichuan Medical Association Orthopaedics(ShangAnTong)Special Research Project(No.2023SAT14) （尚安通）
