3D打印技术用于人工全髋关节置换术治疗成人DDH的临床应用

摘要

目的 本研究拟探究3D打印技术用于人工全髋关节置换术治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)的临床应用效果.方法 纳入2013年1月至2016年6月昆明医科大学第一附属医院骨科Crowe各型成人DDH患者共20例,Crowe Ⅰ型2例,Crowe Ⅱ型2例,Crowe Ⅲ型8例,Crowe Ⅳ型8例.所有患者制造出与实体1∶1的髋关节模型,并制定出合适的手术方案并按方案实施手术.记录患者的一般情况、并发症和患者患髋的功能指标(活动度、疼痛视觉模拟评分、髋关节功能评分).结果 患者平均手术时间为(75.25±20.42)min,下床时间为术后(2.90±0.72)d,平均住院时间为(15.35±5.95)d.患者的髋关节功能评分(harris hip score,HHS)术前平均(51.30±8.02)分,末次随访(86.50±5.85)分,差异有统计学意义(P<0.001);视觉模拟评分(visual analogue scale,VAS)术前为(5.51±1.19)分,末次随访为(1.05±0.88)分,差异有统计学意义(P<0.001).所有患者均获随访,随访期间未出现关节感染、假体松动、假体脱位、坐骨神经损伤等并发症.结论 3D打印技术治疗髋关节发育不良的患者,特别是Crowe Ⅲ/Ⅳ型患者效果显著.%Objective To explore the clinical effect of 3D printing in the treatment of adult developmental dysplasia of the hip(DDH) with total hip arthroplasty(THA).Methods From January,2013 to June,2016,20 patients were diagnosed as DDH in the First Affiliated Hospital of Kunming Medical University.There were 2 cases of Crowe Ⅰ ,2 cases of Crowe Ⅱ,8 cases of Crowe Ⅲ,8 cases of Crowe Ⅳ.All patients underwent spiral CT scanning,and the hip 3D model were calculated to produce a large hip joint model with entity 1︰1.According to print out the corresponding hip model,we developed a suitable surgical program.The general condition,complications and the patient''s hip function (activity,pain VAS score,Harris Hip Score(HHS)) were recorded.Results 20 patients were diagnosed as DDH.The mean operative time was (75.25±20.42) min and the patient could stand and walk (2.90±0.72) d after operation.The average length of stay was (15.35±5.95)d.The mean HHS was (51.30±8.02) before the surgery and (86.50±5.85) at the last follow-up(P<0.001).The VAS score was (5.51±1.19) before the surgery and (1.05±0.88) at last follow-up (P<0.001).All patients were followed up with no complications such as joint infection,prosthetic loosening,fracture,prosthetic dislocation,sciatic nerve injury and other complications recorded.Conclusion 3D print technology was efficient in the treatment of hip dysplasia in patients,especially Crowe Ⅲ / Ⅳ patients.