3D打印个性化股骨侧定位辅助法在膝关节前交叉韧带重建中应用

摘要

目的：评价应用3D打印技术设计个性化股骨侧定位辅助法并应用于前交叉韧带( ACL)重建手术的临床效果。方法收集2015年1月至2016年8月在沈阳军区总医院应用3D打印个性化股骨侧定位辅助法行ACL重建术26例患者为3D组,本组患者术前进行3D建模、ACL股骨侧足印区定位。26例应用常规经膝关节前内侧入路手动进行股骨侧定位的ACL重建术的患者,且每例膝关节功能评分( IKDC)均>85分,设为对照组。通过术后X线评估法评价两组患者股骨侧隧道情况并进行统计学分析。结果两组患者手术过程均顺利,均未出现并发症。3D组术前均建模顺利,术前定位股骨侧隧道口后,股骨侧隧道长约(42．6±4．1) mm,常规组测量股骨侧隧道长约(39．2±3．8)mm,两组间比较,差异无统计学意义(P>0．05)。3D组与常规组NL/ML、AL/BL、α及β角差异均无统计学意义(P>0．05)。结论应用3D打印技术设计个性化股骨侧定位辅助法进行ACL重建手术有助于精准定位股骨侧解剖点,控制导针方向,利于腱骨愈合,降低“打爆”后方皮质的概率。%Objective To evaluate the efficacy of application of 3D printing personalized femoral lateral positioning auxiliary method in ACL reconstruction surgery. Methods From January 2015 to August 2016,26 cases were performed 3D printing personalized femoral lateral positioning auxiliary method(3D modeling,ACL femoral printing area location) preoperatively, and were divided into 3D group. All 26 cases whose IKDC knee functional scores were more than 85 points and perrformed conventional method were divided into control group. Postoperative X-ray evaluation method was performed for evaluation be-tween the two groups. Results Surgery in all cases was successful and no complications occurred. Preoperative modeling in 3D group was smooth. Localization lateral femoral tunnel,lateral femoral tunnel length was(42. 6 ± 42. 6) mm,and lateral femoral tunnel length was about ( 39. 2 ± 39. 2 ) mm. There was no statistical significance between the two groups ( P >0. 05). NL/ML,AL/BL,alpha and beta angle differences had no statistical significance(P>0. 05)between the two gorups. Conclusion Application of 3D printing personalized femoral lateral positioning auxiliary method in ACL reconstruction sur-gery will be good to pinpoint femoral anatomic point,control the needle direction,and will be good for tendon bone healing, reducing the probability of “ringing” rear cortex.