[1]毕文超,梁立卓,刘司南.基于快速成型及3D打印技术全膝关节置换术治疗双膝骨性关节炎临床研究[J].陕西医学杂志,2022,51(6):688-691.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.011]
 BI Wenchao,LIANG Lizhuo,LIU Sinan.Clinical study of TKA based on rapid prototyping and 3D printing in treatment of bilateral knee osteoarthritis[J].,2022,51(6):688-691.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.011]
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基于快速成型及3D打印技术全膝关节置换术治疗双膝骨性关节炎临床研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年6期
页码:
688-691
栏目:
临床研究
出版日期:
2022-06-05

文章信息/Info

Title:
Clinical study of TKA based on rapid prototyping and 3D printing in treatment of bilateral knee osteoarthritis
作者:
毕文超1梁立卓2刘司南3
(1.西安交通大学附属红会医院手外中心,陕西 西安 710054; 2.空军军医大学唐都医院骨科,陕西 西安 710038; 3.西安交通大学第一附属医院外科重症监护室,陕西 西安 710061)
Author(s):
BI WenchaoLIANG LizhuoLIU Sinan
(Hand Surgery Center,Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,China)
关键词:
双膝骨性关节炎 快速成型 3D打印 全膝关节置换术 膝关节功能
Keywords:
Bilateral knee osteoarthritis Rapid prototyping 3D printing Total knee arthroplasty Knee function
分类号:
R 687.4
DOI:
DOI:10.3969/j.issn.1000-7377.2022.06.011
文献标志码:
A
摘要:
目的:比较基于快速成型及3D打印技术全膝关节置换(TKA)术与传统术式治疗双膝骨性关节炎的效果。方法:选取双膝骨性关节炎患者80例,按照手术方式差异分为观察组(48例)与对照组(32例)。观察组采用基于快速成型及3D打印技术的TKA术治疗。对照组采用传统术式治疗。比较两组围手术期指标(手术时间、失血量、术后48 h引流量)。比较两组手术前后膝关节活动度、膝关节功能(HSS)评分及力线[下肢机械轴夹角(HKA)和冠状位股骨远端机械轴外侧角(mLDFA)]。比较两组并发症发生情况。结果:两组失血量比较差异无统计学意义(P>0.05)。观察组手术时间明显短于对照组,术后48 h引流量明显少于对照组(均P<0.05)。术前,两组膝关节活动度、HSS评分、HKA、冠状位mLDFA比较差异无统计学意义(均P>0.05)。术后6周,观察组膝关节活动度、HSS评分显著高于对照组,HKA与冠状位mLDFA明显小于对照组(均P<0.05)。观察组并发症总发生率明显低于对照组(P<0.05)。结论:相较于传统术式,基于快速成型及3D打印技术TKA术能缩短手术时间,减少术后引流量,改善下肢力线,促进膝关节活动度与功能恢复,且可降低并发症发生风险。
Abstract:
Objective:To compare the effects of total knee arthroplasty(TKA)based on rapid prototyping and 3D printing and traditional surgical method in the treatment of bilateral knee osteoarthritis.Methods:A total of 80 patients with bilateral knee osteoarthritis were selected and divided into observation group(48 cases)and control group(32 cases)according to the difference of operation methods.The observation group was treated with TKA based on rapid prototyping and 3D printing technology.The control group was treated with traditional surgery.The perioperative indicators(operation time,blood loss,and drainage volume 48 hours after operation)were compared between the two groups.The range of motion of the knee joint,knee joint function(HSS)score and force line [hip-knee-ankle angle(HKA)and mechanical lateral distal femoral articular angle(mLDFA)] were compared between the two groups before and after surgery.The incidence of complications between the two groups was compared.Results:There was no significant difference in blood loss between two groups(P>0.05).The operation time of the observation group was significantly shorter than that of the control group,and the drainage volume 48 hours after operation was significantly lower than that of the control group(all P<0.05).Before operation,there was no significant difference in range of motion of the knee joint,HSS score,HKA and coronal mLDFA between two groups(all P>0.05).Six weeks after operation,the range of motion of the knee joint and HSS score in the observation group were significantly higher than those in the control group,while HKA and coronal mLDFA were significantly lower than those in the control group(all P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Compared with traditional surgical method,TKA based on rapid prototyping and 3D printing technology can shorten the operation time,reduce postoperative drainage volume,improve lower limb alignment,promote the receovery of knee range of motion and function,and lower the risk of complications.

参考文献/References:

[1] 杨 曼,刘 强,王伟伟.腕踝针结合活血通络方外敷治疗膝关节置换术后疼痛疗效观察[J].陕西中医,2019,40(4):531-533.
[2] Ersan Ö,Öztürk A,Catma MF,et al.Total knee replacement-cementless tibial fixation with screws:10-year results[J].Acta Orthop Traumatol Turc,2017,51(6):433-436.
[3] 杨生森,张 晨,董 毅,等.快速康复外科理论下不留置尿管对单侧人工全膝关节置换术后患者康复的影响[J].陕西医学杂志,2020,49(12):1561-1565.
[4] Adravanti P,Vasta S.Varus-valgus constrained implants in total knee arthroplasty:Indications and technique[J].Acta Biomed,2017,88(2S):112-117.
[5] 刘 浩,吴 博,郑清源,等.个性化股骨远端截骨导向器与传统手术工具在全膝关节置换术中的对比研究[J].中华骨科杂志,2018,38(19):1170-1176.
[6] 李晓博,张 勇.全膝关节置换术围术期静脉配合关节内注射氨甲环酸临床价值研究[J].陕西医学杂志,2019,48(11):1542-1544,1577.
[7] 范 霖,杨 东,刘凯缘,等.全膝关节置换术中间隙平衡截骨与测量截骨技术的对照研究[J].中华骨科杂志,2019,39(15):935-943.
[8] 高小康,仝 超,韩守江,等.3D打印个性化截骨模板在TKA术中的应用[J].中国骨与关节损伤杂志,2018,33(8):802-805.
[9] Chalmers BP,Limberg AK,Tibbo ME,et al.Total knee arthroplasty after high tibial osteotomy results in excellent long-term survivorship and clinical outcomes[J].J Bone Joint Surg Am,2019,101(11):970-978.
[10] 刘金辉,聂喜增,李 锋,等.3D打印技术在全膝关节置换术中的应用价值[J].现代中西医结合杂志,2016,25(16):1760-1763.
[11] Eid AS,Nassar WA,Fayyad TA.Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee[J].Int Orthop,2016,40(11):2289-2293.
[12] 严 清,鲍海星,孙 俊,等.3D打印个体化截骨模板在重度膝关节炎并下肢畸形TKA术中的应用[J].中国骨与关节损伤杂志,2018,33(8):847-849.
[13] 许志庆,王武炼,庄至坤,等.3D打印技术辅助人工全膝关节置换术治疗合并关节外畸形的膝骨关节炎[J].中国修复重建外科杂志,2017,31(8):23-27.
[14] 李 杨,田 华,耿 霄.计算机导航系统、3D打印截骨导板与传统器械对全膝关节置换术手术时间和下肢力线恢复的影响[J].中华医学杂志,2018,98(27):2157-2161.
[15] 张 鹰,杨 宇,刘大鹏,等.数字化快速成型技术在全膝关节置换术中应用[J].临床军医杂志,2016,44(3):234-237.
[16] 邱 冰,唐本森,邓必勇,等.基于三维反求技术和计算机辅助技术的3D打印导板在全膝关节置换术中的初步应用[J].中华创伤骨科杂志,2016,18(1):35-41.
[17] 刘奕宁,刘利春,李晓彬,等.3D打印截骨导板在TKA术中的应用效果分析[J].中国骨与关节损伤杂志,2019,34(2):36-39.
[18] 刘 帅,姚庆强,周 进,等.计算机辅助设计与3D打印个性化截骨导板辅助人工全膝关节置换术的精准度研究[J].中国骨与关节损伤杂志,2017,32(6):580-584.
[19] Kumar P,Vatsya P,Rajnish RK,et al.Application of 3D printing in hip and knee arthroplasty:A narrative review[J].Indian J Orthop,2020,55(Suppl 1):14-26.
[20] 董子漾,李 杨,田 华.个性化截骨导板与计算机辅助导航在人工全膝关节置换术中应用效果比较研究进展[J].中国修复重建外科杂志,2021,35(11):1492-1498.

备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(2019JM-265)
更新日期/Last Update: 2022-06-06