3D打印技术在胫骨高位截骨治疗膝内翻畸形骨关节炎中的临床应用

被引：35

作者：

刘云涛 ^{[1
]}

张新安 ^{[1
]}

王鹏 ^{[2
]}

谢攀攀 ^{[2
]}

黄金承 ^{[3
]}

张永超 ^{[1
]}

连鸿凯 ^{[2
]}

机构：

[1] 郑州大学第二附属医院骨科

[2] 郑州大学附属郑州市中心医院骨科

[3] 河南省人民医院骨科, 郑州

来源：

中华创伤骨科杂志 | 2019年 / 21卷 / 03期

关键词：

膝关节; 骨关节炎; 畸形; 截骨术; 3D打印技术;

D O I：

暂无

中图分类号：

R684.3 [关节炎]; TP391.73 [];

学科分类号：

100220 [骨科学];

摘要：

目的探讨3D打印个性化截骨导板在内侧开放楔形胫骨高位截骨治疗膝内翻畸形骨关节炎中的应用效果。方法回顾性分析2016年1月至2017年1月期间郑州大学附属郑州市中心医院骨科因膝内翻畸形骨关节炎行内侧开放楔形胫骨高位截骨术治疗的16例患者资料。男6例, 女10例;双膝2例, 单膝14例;年龄为49～65岁,平均55.8岁;病程为1～12年, 平均5.3年。术前应用3D打印技术设计并打印个体化截骨导板, 所有患者截骨前应用膝关节镜检查, 使用截骨导板辅助截骨。术前及术后6个月通过X线片测量并记录胫股角、胫骨近端内侧角、下肢负重线比率、胫骨平台后倾角、髌骨高度Insall-Salvati指数。末次随访时按美国特种外科医院(HSS)膝关节评分标准、疼痛视觉模拟评分(VAS)评定疗效。结果 16例患者术后获6～12个月(平均9.1个月)随访。术后6个月胫股角、胫骨近端内侧角、下肢负重线比率、髌骨高度Insall-Salvati指数与术前相比差异均有统计学意义(P<0.05), 而胫骨平台后倾角与术前相比差异无统计学意义(P=0.990)。末次随访时16例患者的疼痛VAS评分为(0.8±0.7)分, 与术前[(4.2±0.9)分]比较差异有统计学意义(P<0.05);HSS膝关节评分为(89.3±6.7)分, 与术前[(61.9±10.5)分]比较差异有统计学意义(P<0.05)。末次随访时根据HSS膝关节评分标准评定疗效:优14膝, 良3膝, 可1膝。结论 3D打印截骨导板在内侧开放楔形胫骨高位截骨治疗膝内翻畸形骨关节炎中能够辅助精确截骨, 有效纠正下肢力线, 术后近期疗效良好。

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